It wasn’t the cocktail of chikungunya, dengue and other ills in the state that had taken a toll of the doctors. As the ad itself said, these white coats had left their posts to go find more lucrative offers in private hospitals in India or abroad, especially in the Gulf. Lists of more such absconders are being prepared for action to be initiated against them.

The lineup is significant. No less than 21 of them were posted in Alappuzha, Pathanamthitta, Kollam, Kottayam and Idukki—the districts worst hit by chikungunya and other fevers that have killed over 200. Most, like Dr S Sajjad of the Community Health Centre in Veliyanad, left their posts four or less years ago. Civil Surgeon Dr Leela Manjiri of the Community Health Centre at Vakkaom hasn’t been seen at the health centre since 1993, but is still on government rolls. And the last time Dr Preethi Hareendran, assistant surgeon at the General Hospital in Thiruvananthapuram, did some work there was more than five years ago.

The result: as Kerala reels under the assault of epidemics, the Government has to plead private practitioners, the Navy, NGOs for help.

Says Dr Sunny Orathil, president of the Kerala Government Medical Officers Association (KGMOA): “The Government recently interviewed and appointed 280 young doctors. Only 65 joined, and many who did left within weeks to join private hospitals.”

Officials said that while government salaries are certainly not high enough to lure doctors, many of the absconders want the best of both worlds: security and pension of a government job and the perks of a private practice. So, Kerala, which famously has the highest number of healthcare institutions in the country, is severely dependent on private medicare. As of last year, the cumulative bed strength of the government hospitals was 43,273, while the private hospitals had 67,517 beds on offer.

Director of Health Services Dr Kutta Mani says, “Salaries are a big issue, working conditions are another, and there are many more.”

Meanwhile, the Health Department is trying hard to woo retired doctors and offering temporary contracts to some from private hospitals. The initiative, leveraging the National Rural Health Mission, offers to pay relatively higher wages to the doctors: Rs 25,000 to postgraduates with over five years’ experience, Rs 21,000 to those with less than five years’ experience, and Rs 15,000 to graduate doctors with no experience.