Few issues resonate as universally across global media as corruption. Whether it's CNN, Fox, or Bloomberg in the global North, or a community radio station deep in Africa’s hinterlands, corruption is one problem that cuts across borders, systems, and societies.

India is no different. Be it our former prime minister talking about the massive failure in last mile delivery or the protests at the Jantar Mantar which marked the dawn of a new political party, the country has seen it all.

On its part, popular media has also contributed to an awareness around corruption by making bold movies, doing 9PM shows and making viral videos of bribery demands amongst others.

However, no revolution-esque discussion on the issue has yet led to transformative results. Gains, if any, are incremental.

In 2024, India was placed at 96th position – down from 93 in 2023 – in the Corruption Perception Index. Institutional changes, digitisation, transparency efforts, special departments to nab bribe-takers have delivered some relief, but have not been able to eliminate corruption from the system.

The question is, what is lacking in these approaches?

One explanation is that corruption has become the grease in the wheels of the economy, which is why public outcry over it is often met with hurried, superficial responses from established institutions.

In order to solve the problem, one needs to know its causes beyond the power hierarchies of executive powers.

Phutani Bhaiya

While writing the character of Phutani Bhaiya in new Gram Chikitsalay series, produced by The Viral Fever, writers Vaibhav Suman and Shreya Srivastava explored a distinct aspect of corruption in everyday life.

Gram Chikitsalay is set in the fictional village of Bhatkandi. Dr Prabhat is an idealistic young doctor, who arrives to revive a rundown Primary Health Centre. He works alongside the quirky compounder Phutani Bhaiya, a lazy ward boy Govind, and an empathetic Nurse Indu, whose son Sudhir battles Dissociative Identity Disorder.

In north Indian villages, the name Phutani is reserved for freeloaders – who suck resources but do not contribute in proportion to their consumption.

In the web series, Phutani has earned this name from villagers for his slyness. Throughout his career, Phutani has learnt to bend his personality according to the need of the hour for manoeuvring through the labyrinthine systems of governance.

“We envisioned Phutani as a character who must have been an idealist like Dr Prabhat when he came into the system around a decade back. Slowly, he started to realise his powerlessness – you know MOs not coming to the health centre, no proper vigilance, patients not being interested and all that. Slowly he changed his way and by the time Dr Prabhat arrives, he has forgotten a large part of his original personality,” said Vaibhav.

When Dr Prabhat arrives, the first question he encounters from Phutani is about his plans regarding returning to his guest house. For Dr Prabhat, a Gold Medallist from top college, it is a cultural shock, which was compounded by the fact that the road to health centre was closed due to an illegal farm and Phutani did not care about it.

Upon realising that his new boss won’t succumb to conventional problems plaguing the system, Phutani has to rush towards his duty, many of whose fine details he has forgotten. Over the next few days, he sees Dr Prabhat working to unclog the rural healthcare system, from clearing the forest path to the centre, to arranging equipment and medicines

Throughout this process, Phutani is calm, chewing tobacco with the nonchalance of a man unbothered by the centre’s crumbling walls. He sulks when his idealistic boss calls him out for corruption, but is also quick to adjust to the new demand of patient-centred infrastructure.

There comes a point when Dr Prabhat questions him about the absence of medicines from the Health Centre. Phutani goes to the local medicine shop to which he regularly sells the drugs. Contrary to his character, he offers to buy the medicines with his own money instead of giving a passive threat to the shopkeeper, which he was fully positioned to do.

This is the point which shows that Phutani is not a hardliner either way. He is unscrupulous when the system demands it, honest when it suits him. Between these two traits, he somehow retains the perception of being a 'good human' in Bhatkandi.

For villagers, Phutani is the man who will smuggle a vial of cough syrup to sell in the local black market, but when the situation demands, he will also not hesitate to put an extra bandage in the old lady’s bag.

Based on his reputation from being a compounder, Phutani has multiple side hustles in the village – farmer, advisor, aid to the quack who treats people when MOs have ditched the village and so on. The multiplicity of roles and duality of character does not turn him into a pariah – instead he is an indispensable force in the system.

For someone like Dr Prabhat, he is an agent of corruption who knows how to act smart.

However, for Bhatkandi residents, Phutani is ‘know-it-all’ of the system, its written rules and unwritten codes. In the world of Phutani and his co-villagers, rules prescribed by Health departments work as idealistic prescriptions which can be moulded according to one's own whims and fancies.

The idealism with which he entered the job did not serve his interest – as his boss Dr Prabhat comes to witness when for two long weeks, not a single patient visited his health centre.

While Dr Prabhat goes the ideal route, he is rebuked, but Phutani and others tell him that MOs before him had no such problem since on paper, patients kept coming and medicines kept getting sold.

Ethically, the question is whether Phutani could do any better. We may have to wait for the new season to know this, but if real life is any hint, the answer is no.

During their research for the character, writers of the show claim that they visited dozens of such facilities in Uttar Pradesh and Bihar.

Phutani is probably the most common archetype navigating through his moral fissures with the finesse of a chess grandmaster. “That is why when his theft of medicine gets caught and Prabhat tries to talk to him, Phutani’s first instinct is to negotiate a respectable percentage of profit sharing. Because, this is what he has seen throughout his career,” said Vaibhav.

Characters like Phutanis are regular features in health department offices as well as other government service institutions. It is the systemic gaps which are responsible for the rise and dominance of such individuals.

The Structural Reality of Rural Healthcare

To understand why compounders like Phutani emerge and thrive, one must examine the structural reality of rural healthcare in India.

According to 'The State of Healthcare in Rural India Report – 2023', over 60 per cent of rural residents have to migrate out of their state for major treatments. For the Northeast, it jumps to 84 per cent, while the corresponding figures for East and Central India are 66 per cent and 61 per cent.

At an all-India aggregate, a little over 10 per cent of rural India went to a public primary healthcare facility to receive treatment for a serious ailment. The majority would go to a government-run secondary-level facility (60 per cent). About 22 per cent went to a private facility, mostly hospitals, while just over 5 per cent consulted a private medical practitioner.

The problem is skewed by the fact that most doctors trained in medical institutions – both subsidised and private – do not want to turn their attention to rural healthcare. About three-quarters of Indian medical expertise is engaged in service of urban areas, which house less than one-third of the population.

According to 'Rural Health Statistics 2020–2021', there is shortfall of 8,503 sub-centres in tribal areas (the fictional village of Bhatkandi in the show is itself shown in a tribal region).

Moreover, as compared to the requirement for existing infrastructure, there is a shortfall of 83.2 per cent of surgeons, 74.2 per cent of obstetricians & gynaecologists, 82.2 per cent of physicians, and 80.6 per cent of paediatricians.

Overall, there is a shortfall of 79.9 per cent of specialists at the Community Health Centres (CHC) as compared to the requirement for existing CHCs.

In such a perilous state, not a lot of doctors are ready to serve in villages, knowing fully well that they could end up in a situation where the burden of responsibility will be disproportionately on them. It is either doctors with an administrative tilt or full devotion to the cause (like the fictional Dr Prabhat), who end up in government-funded health centres.

Once they land, there is a whole new set of cultural problems waiting for them. As Tishia Srinath, a medical fellow and recent MBBS graduate, tells Swarajya – “Firstly, villages have their own methods of treating health problems. They have trust in their own medicines, home remedies, Ayurvedic medicines or other medicines they try. It is just a different approach to what doctors are taught. If someone realises that their method is not working for them, they will switch to another branch.

"Secondly, it is about the trust factor. People in villages are mostly inert and conservative while opening up to an outsider. When an MBBS or post-graduate doctor comes to rural areas and tries to set things up, it is not easy unless he comes from that area. He is a stranger to them. He will have to work his way into the hearts of people. For that, a mature approach – irrespective of age – is required. They will have to be very, very patient. If someone looks old or wise, a rural person is more likely to trust them.”

Another reason why doctors are not keen to devote many years in service of rural PHCs is perhaps due to the limited exposure offered to them at such levels.

“In villages, Gram Chikitsalays are equipped with very basic infrastructure, serious cases are very rarely treated, it at most serves as a place of transition for both the doctor and the patient. For the patient, it becomes the place where basic stabilisation is provided and thereafter, they are referred to a bigger hospital. For the doctor (usually an MBBS graduate fresh out of internship), it serves as a place of learning, a placeholder, to ensure there are no gaps in their CVs, while they prepare for PG exams, as most seek to specialise.” said Dr Tishia.

This constant turnover of doctors in rural areas creates a gap, and that’s where characters like Phutani step in.

The Gram Chikitsalay show captures this dynamic through Dr Prabhat Sinha's journey. Unlike the typical MBBS graduate treating rural service as a brief career pit-stop, Dr Prabhat arrives with genuine commitment to serve. In the process, showmakers have essentially captured how people like Phutani become essential bridges in this fractured system.

He guides the doctor through his emotional struggle to serve the poor, but more importantly, he provides the continuity that absent or rotating doctors cannot.

For the system, this is the biggest value Phutanis – a representative of the local employee who is adept at change – brings to the table. They are ambassadors of local culture to the outside world.

The compulsion of being organised in a large group of more than a billion people has come with the phenomenon of requirement of such individuals to ensure last mile delivery, through transparent means and otherwise.

These small-scale Phutanis keep systems functional. The electrician ensures power flows, the clerk speeds up discharges.

Economic impact of fixers

A 2021 Journal of Democracy article on India’s “opaque state” argued that red tape and patronage create fertile ground for fixers. Like Phutani, these people have their feet in multiple boats. They are property dealers, brokers for advocates, gateway to high offices in local administration and last source to the last mile of service delivery mechanism devised by the government.

While Phutani struggles due to his mixed nature, there are brute examples of Panchayat level fixers constructing multiple houses and establishing multiple businesses - all thanks to their ‘connections’ to higher offices.

Beyond the Moral Binary

The phenomenon of corruption is a consequence of tons of such compromises. In this dark area though, there are many grey zones.

What sets Phutani Bhaiya apart is his ability to make an average person feel that he is a part of their daily lives. Phutani does not function from an ivory tower of bureaucracy. He is an everyday villager who regularly participates in community programs as an average social animal.

The actions of individuals like Phutani Bhaiya will raise pertinent ethical questions. Is it justifiable to bend rules for the greater good? Where does one draw the line between necessary compromise and ethical transgression?

These questions do not have straightforward answers, as the context often dictates the morality of actions. While their methods may not always align with official protocols, their intentions often aim at delivering results.

At the end of the day, rules are consequence of human practices, and not other way around.

Abhishek Kumar and Adithi Gurkar

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