On its 79th Independence Day, our nation paused to reflect on its long journey marked by achievements, failures, and promises still unfulfilled. Yet, while most were preparing to celebrate freedom, I, like many others, was caught in a very different race, a race for treatment, the most basic requirement for living a dignified life.

Seventy-nine years later, countless Indians still find themselves in lines of suffering, forced to surrender their dignity just to receive care. Our healthcare system has, in many ways, become an arena where the sick fight not only their illness but also the very system meant to protect them.

A family’s battle with the system

I have experienced this several times in the past, but the most recent one was when my father was diagnosed with chronic kidney disease (CKD). This Independence Day, the very system demanded that my freedom should be spent trying to claim my father’s most basic rights. As a son, I did that, or at least tried to do that.

My father, who is almost 70, was moving towards kidney failure, a condition that has, in recent years, emerged as a significant public health concern in India. 

In the 8–9 months after his symptoms began, we had tried every private and government facility available in Haldwani, Uttarakhand, but nothing helped. So we turned to the last resort for millions of Indians, AIIMS Delhi, to consult a senior nephrologist. That is where our real journey for treatment began.

As per estimates, AIIMS, being one of the largest hospitals in the country, consumes nearly 4–5 percent of the national health budget. According to some media reports, it has registered at least 50 lakh OPD patients, admitted more than 3.5 lakh patients, and performed nearly 3 lakh surgeries since the start of the year till September 2025. The scale and daily rush here are difficult to grasp when you pass along the Ring Road and see the massive, silent buildings within its walls. 

All those who have visited AIIMS, and especially those who work there, know how chaotic, relentless, and exhausting the environment inside can be, consuming you physically, mentally, and emotionally. Since my father was already registered there, I thought the process would be easier. But I was wrong.

A journey marked by delays

When I tried booking an online appointment for a general physician, the dates were unavailable, which meant I had to travel to Delhi just to secure a slot in the medicine department. I boarded a train from Uttarakhand carrying not just the reports but also many hopes.

After a month, we finally secured an appointment with a doctor from the Medicine department who examined my father, prescribed some medications, and asked us to return after a month with updated reports. When we did, the new reports showed a worsening of his condition. Meanwhile, my father had lost weight and endured sleepless nights due to his persistent cough. Finally, we were referred to the nephrology department, which brought me a sense of relief as at last, a kidney specialist at AIIMS would see my father.

I had been to AIIMS several times before and can recall several sleepless nights spent on footpaths and in underpasses alongside hundreds of others waiting for their treatment for months, and in some cases for years. I was hoping that things would be easier now, especially with the government’s investment in healthcare and the 18 more AIIMS institutions functioning across India. But even after all these years, I found much of the system to be more complex and insensitive, if not for all, then certainly for many.

The hidden hardships behind accessing apex hospitals

After being referred, when I reached the registration counter on the ground floor, I was told that there were no offline or online appointments for the next few days and that, in case of urgency, I should check with the nephrology counter on the fourth floor. Upstairs, the answer was the same: “no cards today.”

That night, I stayed awake with my laptop, refreshing the portal page every few seconds, but with no luck. Every slot was already taken for the next month. Since I could not expect a machine to understand my urgency, I decided to visit the hospital again early in the morning to check if Tatkal cards (same-day cards) were available.

Around 6 am, I was at AIIMS, standing among thousands, children, the elderly, the blind, the disabled, and the seriously ill, who were waiting outside the giant OPD building named after India’s first health minister, Rajkumari Amrit Kaur. When the gates opened at 7 am, people started rushing into the building and running towards their respective floors. 

I saw dozens of patients running on escalators, as those who were familiar with the system knew that the lift was a risky option because every second mattered. The way they were running, it seemed as if the race for treatment had made them forget their illness and pain.

I reached the counter and secured the second position in the line. After waiting for more than an hour, the window finally opened, but the answer was the same as the day before: “Aaj cards khatam ho gaye hain. Aap kal check kijiye.” (Cards are finished for today. Please check tomorrow.) I could not understand how not a single card was issued that day from this counter when every hospital has some slots available for outpatients on a Tatkal basis. 

Even the online appointment slots for the next few days were full, as per the receptionist. I wondered if this was the consequence of the recent resignations of doctors from AIIMS Delhi. I am sure the doctors have their own stories about what the system is doing to them.

After two sleepless nights refreshing the hospital portal, I finally managed to get an appointment, but it was for one month later. By then, two months had already passed without any improvement, so I decided to go there again and explain my urgency.

The race, guilt, and lines of hope

This time, I managed to secure the first spot in the line because I could run faster. But I felt guilty for leaving so many behind who might be in greater need, like the very old lady who could barely walk in the rain, using her hands on her knees for support because of her weak legs. I could have helped her by sharing my umbrella or holding her hands, but I knew the cost of my compassion, as every second lost meant another place lost in the line. Therefore, I just kept walking, ashamed and without the courage to make eye contact with her.

An uncle was standing behind me in the line, and I sat on the cold floor and waited for an hour. During our conversation, I learned that he was 65 years old and had been running around for several days just to get an appointment for his son, who had lost sight in one eye and was now losing vision in the other. Without clearance from the nephrology department, the surgery might be postponed or even cancelled. So I offered to let him go first.

Since our counter started a little later than the next one and because uncle took a few extra seconds to show his papers, two people standing in the other line managed to secure an appointment for 10 days later. One of them was an uncle in his sixties who had been part of the same race for the past few days. He had relief on his face, not because his condition was better, but because he had finally secured the chance to meet the doctor.

No more appointments were given after that. We were told to check online, check on the ground floor if they had any Tatkal cards left, or come again tomorrow. Uncle and I moved from floor to floor speaking to different people, and after wasting another hour, we were just as clueless as we had been four days earlier. Then a helper in a yellow jacket from AIIMS suggested we go to the Ashray shelter for new cards. With some hope and our bundles of reports, we both left for Ashray.

Ashray: shelter, struggle, and uncertain hope

Ashray, located behind the AIIMS Trauma Centre, is a shelter home run by the CRPF Family Welfare Association in collaboration with AIIMS New Delhi to provide temporary shelter for patients and their families who come for treatment at AIIMS. There, we were told that OPD cards would only be issued if slots were available and that, for this, the patient had to stay in the shelter with one attendant. 

Since only 4–5 nephrology patients were given cards each day and 30–35 patients were already waiting, this meant at least 4–5 days of stay in the shelter. The thought of such a wait discouraged the uncle and broke his hopes. Disappointed, we both left the place. I accompanied him to the metro station, where I shared my number in case he needed any help. He never called, so I do not know what happened to him.

Although there have been frequent news reports and many memoirs about the struggle to get treatment and the long waiting periods at AIIMS for many surgeries, sometimes stretching up to two years, very few cover the struggle to even secure an appointment with a doctor. While doctors may give preference to those critically ill, that usually happens only after admission. But without an OPD card, there is no recognition of an emergency.

By then, I was physically and mentally exhausted and returned to the place I was staying. Yet, my hope was far from broken. Meanwhile, we visited private hospitals and consulted nephrologists, a route unaffordable for most families. Most advised preparing for dialysis, given his age, while some suggested a transplant could also be considered. However, before committing to any costly treatment plan that would have been nearly impossible to bear, we wanted to hear the opinions of experts at AIIMS.

By this time, my father had gone back to our hometown as he could not leave the house for long with no assurance of the appointment. I returned to Ashray two days later, determined to stay until I had a card for my father.

Night at Ashray: enduring the limits of shelter and patience

I reached the shelter around 9 pm and joined the line formed inside the big compound where Ashray was located. Dozens were already standing outside the entry gate before me, and several hundred were already inside, waiting to get a token for the night stay.

The CRPF soldiers must be appreciated for doing their best to help people already suffering, but the shelter was trying to do much more than it was designed for. There seemed to be at least twice as many people as the shelter was built to accommodate.

The compound was far from comfortable. The floor was muddy and wet, full of mosquitoes and wandering animals. People sat on whatever they could find. Everyone present there had a story to share, often reflecting the neglect and harshness of the Indian healthcare system.

There was a boy with his ill aunt, who had to return empty-handed as he had no Aadhaar card, and by then it was already midnight. A police officer with a recent head surgery who had been referred here from AIIMS Jhajjar for an expert opinion. An old lady from Agra, carrying an unforgettable smile even in those conditions, though her accompanying friend kept disturbing her by complaining that she could not sleep because of the big insects around her bed. An uncle with a calm face sat unmoved even when it began to rain.

Yes, it started raining, and most of us started finding shelter or something to cover ourselves. Our patience was being tested. Maybe it is the suffering one is willing to endure that decides who gets treatment on time and who does not.

Past 1 am, the gate was finally opened. An official from inside came out and started checking our papers. The first announcement was blunt: “Gastro cards khatam ho gaye hain, gastro wale kal aaye.” (Slots in Gastroenterology are over, please come tomorrow.) People who had been waiting for hours were simply told to leave without any clarification or future assurance.

The calm, smiling uncle was also asked to leave as he had no attendant with him. He kept pleading and explaining that he had no one at home who could come. But the man, we found, was ruthless. Perhaps the daily process of managing the crowd and turning people away made him and many others like that.

When I explained my father’s conditions and the desired department, I was told, “No nephrology slots available,” and I should come later. Standing there with no success, I felt like I was going through the punishment of Sisyphus, pushing the rock up the hill only to find myself back at zero to start again.

Meanwhile, the uncle was still in shock, praying silently for a miracle. The pain and helplessness on his face were visible. I went to him and said, “Please tell the guard that I have come with you.” Uncle, still in shock, took me along. I do not know whether the person recognised me or acted out of compassion, but he let us both in.

Endurance in the lines: when compassion meets chaos

Now, Uncle was standing in another line inside the gates for a token. I decided to spend the night with him and try again at the registration counter in the morning. So I started looking for a place to sleep, as all the tents were overcrowded and many people were lying outside in the open.

Meanwhile, I heard chaos at the entry gate. In that chaos, two daughters were pleading and crying to let their mother inside. But the guards were adamant, as two family members were already inside. The daughters argued that it would be difficult for their mother to stay outside, exposed to rain, insects, and no security.

On the other side, uncle was in a dilemma since he had to choose only one of the two departments he was referred to. When he got the token, he was relieved and had no words to thank me.

I asked if we could help those daughters and their mother. He nodded. That is another story in itself, where I had to convince many people blocking the gates and ready to barge in to let the mother in while I stepped out, as she could not be left outside in the compound, and no child should have to witness that situation. 

Luckily, the guard had left for a while, so our swap could happen. The mother went inside, staying under the guise of the calm uncle’s wife, and I stepped outside again and started thinking about the next step. I do not know if they managed to meet the doctors in the morning, but at least there was hope as they were inside.

With my experience, I learned that to be the first in line to get an appointment, you have to be part of several lines of suffering before, which tests you to the core to know how much you can push yourself.

When healing demands the sacrifice of dignity

While leaving the compound, I saw dozens of patients and their relatives standing on the road outside in the dark who refused to leave. They were waiting for another day, another chance to be part of the line again. I wondered about those who came from outside Delhi.

I realised that the very purpose behind the shelter was being undermined, as many more could have been accommodated if Delhi residents were not required to leave their own homes just to get their OPD cards from Ashray. I wondered what would happen to people like them in the winter.

It was a lot to think about. In such moments, you forget yourself. I knew nothing could be done, so I left for AIIMS at 2 am, passing through the courtyard of the Safdarjung emergency building. I stayed there for a while, enjoying the air-conditioned air coming through the open gates, but had to leave as I could not bear the screams of families grieving their dead.

Outside AIIMS, I met the same police officer uncle from Ashray who was helping his son spread a bedsheet under an empty chai shop to avoid possible rain. We had a brief chat, and after that, I went inside searching for a place to rest. After scanning the area twice, I finally found a place among those lying there looking more like dead bodies than patients who were gathering what little strength they could before the race resumed in the morning.

I rolled my bedsheet near an already sleeping lady, most probably from West Bengal, and closed my eyes. I could hardly rest for 20 minutes as it started raining heavily around 3:30 am. Everyone, including children, the elderly, and the seriously ill who were sleeping, woke up in seconds and began saving their bags and belongings. Those sleeping in the open rushed into the already congested and overcrowded area.

In that moment, soaked and sleepless, most of them shared the same feeling. Their pain and vulnerability were written on their faces. At 4 am, in that heavy rain, we could see our dignity drowning before our eyes. I do not remember the last time I observed rain the way it was crashing on the plastic roof or touching my face as it did that day.

When the rain stopped, I bought a cup of tea and began a 2 km walk towards RAK OPD, as there was no transport facility available so early in the morning. When I reached, I saw guards marching patients and their relatives to some other covered space.

I asked one of the security guards, after explaining the seriousness of my father’s condition, where I should stand among the hundreds already waiting in line. He shook his head and said, “No point. Too many people. You won’t get a card today for sure. If it’s an emergency, go to Ashray. That’s your best option.” I wanted to tell him where I had just come from, what I had been through for the last few days, but I knew it would change nothing. So I left the place empty-handed and began to think about other possible alternatives.

Healthcare as the true test of freedom

The next day was a holiday, and the whole nation celebrated Independence Day. I wondered how freedom would have been celebrated by those waiting inside Ashray, those sleeping on footpaths and in underpasses simply to secure one of the most sacrosanct and valuable rights of a citizen and an equally sacred obligation of the State. Would they be happy, celebrating, or frustrated that the holiday meant spending a few more days in those same lines of suffering?

I found myself recalling Nehru’s words from his historic speech, especially the line that strikes me deeply, where he said, “the ambition of the greatest man of our generation was to wipe every tear from every eye.” 

At AIIMS, I saw countless Indians still waiting for this promise to be fulfilled. Therefore, whenever I see chest-thumping on stages or hear news reports and speeches about achievements in the healthcare system, they feel, to a large extent, stripped of the ground reality faced by millions still running from pillar to post for treatment, surrendering the very values we sought to protect in a free country.

We may have won the battle for political freedom 79 years ago, but if true freedom means living with dignity and equal opportunity, then healthcare must become our unfinished freedom struggle.

Lessons from the frontlines: making healthcare accessible and dignified

Based on my first-hand experience, I have a few suggestions that, if implemented, could help make the process of providing quality and timely care smoother, more sensitive, and more efficient for citizens. 

AIIMS, which consumes around 4 to 5 percent of the national health budget, handles an enormous patient load because of the deep trust people place in the institution. However, shortages of staff and resources contribute to appointment delays that compromise care.

The government must build greater trust in the recently opened AIIMS institutes across India so that patients distribute themselves more evenly across facilities. Strengthening primary healthcare centres, district hospitals, and newer AIIMS institutions would ease pressure on apex centres and reduce the long distances that patients currently travel for treatment.

The present OPD appointment system at AIIMS is severely overwhelmed. Online slots are extremely limited, and walk-in options are unpredictable, forcing patients and caregivers to make repeated visits, stand in long queues, and still leave without any certainty of being seen.

A transparent and patient-centred appointment system with real-time availability, advanced visibility of open slots, and prioritisation mechanisms for serious and complex cases is urgently needed to improve access and reduce unnecessary hardship.

Shelters and accommodation facilities near major hospitals, such as Ashray, are overcrowded and often operate in poor hygiene and safety conditions. Many outstation patients who cannot secure a place are forced to spend nights on footpaths, in underpasses, or in the open, which not only undermines dignity but also worsens existing health problems.

The central and state governments should establish minimum standards for patient-stay facilities, increase funding for safe and clean accommodation, and integrate social support services such as transportation assistance and subsidised food to ensure that patients are not further burdened while seeking care.

A nation’s health system is a reflection of its values, and the measure of its progress lies not only in infrastructure or budgets but also in the experience of its most vulnerable citizens. If India is to fulfil the promise of freedom in its truest sense, dignified and accessible healthcare must be recognised not as an aspiration but as an essential responsibility.

Edited by Parth Sharma
Image by Janvi Bokoliya