Guwahati’s Healthcare System: How Public and Private Systems Impact Patient Care

Tamanna Nasreen & Joydeep Paul

In Guwahati, the journey to healing often begins with a silent compromise, between what one can afford and what one truly needs. For many, healthcare is not a question of quality, but a matter of survival.

The city’s public and private hospitals reflect two very different faces of that struggle. In the heart of Guwahati, where the Brahmaputra flows steady and ancient temples whisper stories of the past, the present tells a different tale, one of quiet suffering and complex choices.

The city’s hospitals see thousands every day, not just people seeking treatment, but families seeking hope. Their journeys begin not at the doctor’s chamber, but much earlier, at the crossroad where they must choose between public care they can afford and private care they likely cannot.

Take a walk through Gauhati Medical College and Hospital (GMCH) and you’ll witness it firsthand. An elderly woman rests her back against the wall, eyes closed, clutching her prescription. Beside her, a young boy in school uniform holds his father’s IV drip as they wait for a bed that may never be free. Inside these walls, illness becomes a communal burden carried by families, neighbors, and strangers alike.

The wait is long. Some patients arrive before sunrise just to see a doctor. Many wait hours, sometimes in pain, sometimes in fear. A survey of 200 patients across GMCH, Apollo, and Nemcare hospitals showed that more than half of those at GMCH waited over an hour for consultation.

This isn’t just a number. It’s a mother sitting with her feverish child, wondering if she should leave her job for the day to hold her place in line. It’s a father missing his train back to Barpeta, because the doctor running late is his only hope.

Meanwhile, at Apollo and Nemcare, the silence is striking. The air is cool, the lights soft, the receptionist smiles. Appointments are taken on tablets, names appear on LED screens, and the wait, if any, is within an hour, often less. It’s a different world, clean and calm. But not everyone is allowed inside. The cost of entry is steep, and for many, out of reach.

One cannot ignore the state of cleanliness in these two worlds. At GMCH, we saw patients sharing benches with half-eaten meals, the smell of phenyl failing to mask the staleness of human crowding. Toilets were frequently unusable, and hospital floors doubled as beds for those too weak to stand.

In sharp contrast, Apollo’s corridors gleamed. Every spill was swiftly mopped up, every bin emptied before it overflowed. Even in Nemcare, where perfection wasn’t always guaranteed, the difference was tangible.

But beyond appearances lies the heartbeat of any hospital, its people. And this is where stories both inspire and disappoint. At GMCH, staff were often distant, sometimes overwhelmed. Patients shared how they felt invisible, not just from the rush, but from how little time anyone had for their pain. Only a third felt they were treated with respect.

Yet, one must wonder: what does empathy look like when you have hundreds waiting outside your door?

Private hospitals had the advantage here. Nurses smiled more, doctors explained more. Patients left feeling seen, if not always cured. We spoke with Simtherla Chothe, head nurse at Nemcare, who described the pressure her team faces daily, juggling records, hygiene, dietary needs, and patient updates in a single shift.

“Sometimes we don’t sit for hours,” she admitted. Yet the training, the structure, and the teamwork help keep things steady.

Still, GMCH holds a strength the others simply cannot compete with – accessibility. For those with no money, no job, no family support, GMCH is a beacon. It’s where treatment is possible even when hope isn’t.

Over 77% of patients found the care affordable – many received it free of charge, thanks to schemes like Ayushman Bharat.

Dr. Pranab Bhattacharya, Head of Cardiology, reminded us how essential these government initiatives are.

“Most of our patients are poor,” he said. “Without these schemes, they would simply die at home.”

But knowing about help and receiving it are two different things. Many patients, particularly the elderly or illiterate, are unaware of the schemes available to them. Posters and announcements often go unnoticed. Volunteers are few, and guidance even fewer.

Both public and private hospitals scored poorly on informing patients about available benefits. Getting lost in a hospital isn’t just frustrating, it’s terrifying.

At GMCH, nearly half the patients couldn’t find their way without asking multiple people. Signboards are missing or in English, hallways lead to nowhere, and help desks are overwhelmed.

Dr. Mallika Bhattacharya, head of Gastroenterology at GMCH, spoke about this with concern. She recommended signs in Assamese and Hindi, and more visible help desks, especially near entrances.

Even within GMCH’s overcrowded ecosystem, glimpses of commitment and innovation shine through. Dr. Mallika, who now leads one of the hospital’s busiest departments, shared how the introduction of a DM course in Gastroenterology has transformed their academic culture.

Students, interns, and residents are now actively involved in patient care, diagnostics, and emergency handling, providing critical support to faculty members. Her department alone manages over 1,500 patient interactions weekly.

She also emphasized how integrated diagnostics and Annual Maintenance Contracts (AMCs) have improved care delivery by reducing delays and ensuring functional medical equipment.

While GMCH struggles with volume and resources, private hospitals offer structure, efficiency, and specialization. But they, too, have internal challenges.

At Nemcare, Head NurseSimtherla Chothe revealed that nurses face intense pressure juggling clinical care and administrative duties. Each nurse must document medication, hygiene, and patient updates while maintaining coordination with consultants and attending rounds.

“Sometimes we don’t sit for hours,often in 12-hour shifts.It’s not just skill, it’s stamina,” she said.

Nurse Chothe’s biggest concern? Private hospitals hiring inexperienced nurses to cut costs. “You can’t compromise experience when people’s lives are involved.”

However, she also highlighted a robust internal training program and regular patient feedback mechanisms that help keep the quality of care consistent.

One issue both sectors must confront is communication. In GMCH, barely one-third of patients said they clearly understood their diagnosis or treatment. In Apollo and Nemcare, the numbers were better but not perfect. A warm smile is comforting, but it cannot replace clarity. Patients must leave knowing what is wrong, what has been done, and what to do next.

Despite everything, the wait, the discomfort, the chaos, more than half the patients at GMCH said they would recommend the hospital to others. Not because it’s the best. But because it’s theirs. Because it’s still open. Still trying. Still free.

Apollo and Nemcare fared better, with 78% patients saying they would recommend them. But behind that trust lies the fear that quality is no longer everyone’s right –it’s become a privilege.

Guwahati is growing. So is its population. And with that growth comes responsibility. We need more than one GMCH. We need public hospitals that can match private ones not in luxury, but in dignity. Clean toilets, kind words, clear directions – these aren’t dreams. They’re the bare minimum.

Private hospitals too must step up. They cannot remain islands of efficiency for the few. Through partnerships, subsidies, and outreach, they must become more accessible to those left behind.

In the end, hospitals are more than buildings. They are spaces where life bends but does not break. Where people come scared, tired, and poor, and leave –if lucky – a little less so. It’s not just about saving lives. It’s about how we treat them while we do.

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