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The Art of the Scrub
Turning a Rural Hospital into a National Benchmark
Standing with Giants
In the world of Indian healthcare, there is a certain hierarchy that everyone silently accepts. On one side, you have the “Institutes of National Importance”—the gleaming, well-funded giants like AIIMS New Delhi or PGIMER Chandigarh. On the other side, you have the rural teaching hospitals, often struggling against the tide of dust, crowds, and limited resources.
On 20 April 2018, that line blurred.
Dr. B. S. Garg and I found ourselves in a grand hall in New Delhi, standing before the Union Health Minister to receive the Kayakalp Award. The Government of India had launched this initiative to complement the Swachh Bharat Mission, creating a rigorous national competition for cleanliness, hygiene, and infection control.
When the final rankings were announced for institutes of national importance, the list read: AIIMS New Delhi, PGIMER Chandigarh, JIPMER Puducherry—and then, MGIMS Sevagram. We were ranked fourth in the country. For our 984-bed facility, tucked away in a village in central India, to stand shoulder-to-shoulder with the titans of Indian medicine was a moment of profound, quiet pride.
The Invisible Discipline
This recognition didn’t fall from the sky. It was the result of a conscious, almost obsessive, focus on what I call “the invisible discipline.”
In a large hospital, cleanliness is often treated as a cosmetic exercise—something you do hurriedly when you hear an inspector’s car pulling into the driveway. We wanted to change that culture. We implemented the Mera Aspataal (My Hospital) initiative, which allowed us to systematically collect feedback from the people who matter most: the patients.
We realized that for a patient, a clean toilet or a dust-free locker isn’t just a comfort; it is a sign of respect. It tells them that even if they are poor, they deserve a dignified space to heal.
A Day in the Life of a Ward
I often spoke to our nurses, supervisors, and sweepers about what Kayakalp really meant. I tried to move away from the jargon of “biomedical waste management” and speak about the daily rhythm of the ward.
I’d ask them to imagine a hospital where the day doesn’t begin with a medicine round, but with a battle against the small things. It starts with the quiet removal of a cobweb in a high corner. it continues with the clearing of waste and the scrubbing of a stretcher. It involves decluttering a cupboard that hasn’t been opened in years and discarding old, yellowed files that no longer serve a purpose.
We focused on the details that often go unnoticed until they fail: the availability of safe drinking water, the meticulous sorting of biomedical waste into color-coded bins, and the constant, rhythmic washing of hands. We treated the corridors, the kitchens, and the labor rooms with the same reverence as the operating theaters. In Sevagram, cleanliness stopped being a “task” and became a commitment.
The Six Pillars of Care
During the assessment, the Ministry of Health looked at six specific parameters: hospital upkeep, sanitation, waste management, infection control, hygiene promotion, and overall cleanliness.
While these sound like administrative headings, they are actually the pillars of patient safety. Proper infection control means a mother doesn’t leave the hospital with a fever she didn’t have when she arrived. Good waste management means a needle-stick injury doesn’t change a young sweeper’s life forever. By aligning ourselves with these national benchmarks, we weren’t just chasing an award; we were building a safer sanctuary for the 2,500 people who walk through our gates every day.
The Patient’s Voice
Perhaps the most gratifying part of the journey was the feedback we received through the Mera Aspataal portal. Patients were rating us in real-time. To see a farmer from a nearby village give us a high score for cleanliness was more rewarding than any certificate.
Competing with twenty-one massive, city-based institutions was a David-and-Goliath story. Those hospitals have thousands of staff members and budgets that dwarf ours. Yet, Sevagram rose to the occasion because our staff didn’t see themselves as just “cleaners.” They saw themselves as the first line of defense against disease.
For all of us, the Kayakalp award was an affirmation. It proved that discipline is not a matter of geography or budget. It is a matter of will. It showed that even in a village, you can create a world-class environment if you are willing to pick up a broom with as much heart as you pick up a stethoscope.