Before I started medical school, I used to pass the same government hospital every day on my way to school. It was one of those places that offered “free treatment,” but even as a teenager, I could sense that the care was often just for the name. I remember going to school the next day at around 6:30 a.m., I saw a man sitting outside the hospital, the same man I had seen the previous morning at 6:30 a.m., still waiting.

He hadn’t been called in all day. Patients were made to wait outside, sometimes for days, sometimes for nothing at all. The loudspeaker crackled every morning, shouting names into a crowd that never seemed to move. It was the kind of routine neglect that didn’t make headlines but I saw it every single day.

These moments stayed with me, not just the man outside the hospital for two days but also what I witnessed during a visit to an NGO working in menstrual and reproductive health.

During a simple awareness session, it became clear that many women had never been educated about menstruation, basic genital hygiene, or the importance of safe sex. Some reused cloth without proper washing, increasing their risk for urinary tract infections and pelvic inflammatory disease. Others believed harmful myths about contraception or had never heard of STIs. In some cases, untreated infections could silently cause infertility or complications during pregnancy.

These weren’t just gaps in knowledge, they were risk factors for long-term morbidity. I saw how, in the absence of education and access, preventable conditions became inevitable.

During my shadowing days at a hospital in a rural area, I saw an elderly man sitting alone on a bench, clutching a worn-out file. A nurse had told him to go get his appointment slip by himself but he looked completely lost.

There were no signs he could understand, no one to guide him, and no caregiver with him. He looked weak, possibly hungry, and far too frail to be navigating that system alone. In many rural hospitals, where staff are overworked and systems underfunded, patients like him are expected to manage on their own even if they’re dealing with something as complex as a stroke, dementia, or Parkinson’s.

What struck me most wasn’t just the medical gap, but the silence. No one stopped. No one asked. And in that silence, I saw what it really means to fall through the cracks.

Globally, AI is already playing a growing role in reducing the kind of gaps I witnessed. In India, tools like Qure.ai help detect tuberculosis and brain hemorrhages on scans in hospitals without radiologists. In Rwanda, Babyl offers AI-assisted primary care through mobile phones, serving millions who might not otherwise see a doctor. Aidoc scans CT images in emergency departments to flag strokes or internal bleeds.

AI-powered ultrasound systems help midwives detect complications in pregnancy. These tools are impressive but they still rely on infrastructure, electricity, and digital access.

The irony is that the people who need innovation the most are often the last to benefit from it.

Globally, more than 4.5 billion people still don’t have full access to essential health services, and nearly 2 billion of them live in rural areas.

In some places, around 80 percent of specialist doctor posts in rural community health centers are vacant and almost half of the world’s health care facilities don’t even have basic hygiene, no soap, no clean water. These aren’t just numbers.

They’re quiet emergencies that happen every day. Seeing them up close made me realize something: medicine isn’t just about writing prescriptions. It’s about listening, noticing, and showing up, especially for the ones no one else does.

Real-world solutions to health care gaps

Task-shifting to community health workers. In countries like Malawi and Bangladesh, trained non-physician health workers provide frontline care, helping reduce maternal deaths and manage chronic diseases where doctors are scarce.

Telemedicine platforms bridging rural-urban gaps. Programs like India’s eSanjeevani and Brazil’s Telessaúde let rural patients consult city-based specialists remotely, often through government-run primary health centers.

Health education via WhatsApp or SMS. Mobile messaging can be used to raise awareness about vaccines, HIV prevention, and diabetes management, reaching people with limited internet access.

Solar-powered mobile clinics. Mobile vans equipped with basic diagnostics which run on solar power bring health care directly to villages with no electricity or permanent facilities.

Doorstep care through trusted local workers. Home visits by trained, community-based health workers, such as Ethiopia’s health extension workers, improve follow-up, adherence, and trust, especially among vulnerable groups.

These early experiences have already shaped the kind of doctor I want to become. Not just someone who treats disease but someone who sees the person behind the diagnosis. Someone who speaks up when systems fall silent. If we want to build a more humane health care system, it has to begin with paying attention, especially to the ones who are easy to overlook.

Maanyata Mantri is a medical student.