India, Dec. 26 -- In a few days when Mumbai welcomes the New Year, we also enter the centenary year of one of its great institutions. Great, for its interesting history but mainly for its contribution to alleviating the suffering of millions of ordinary citizens over the years. Mumbai's King Edward Memorial (KEM) Hospital turns 100 in 2026. Its founding in 1926 had huge political significance for the city and even the country. It was a hospital built by natives for the natives in response to the British stranglehold over health services. Strangely though, KEM is a rare institution in Mumbai that has escaped a change of its original British name. It's probably because the acronym has become a global brand. At the turn of the 19th century, Bombay had only one large public hospital, the Sir JJ Hospital with Grant Medical College affiliated to it. This was established, controlled and largely manned by the British or British-picked doctors. Indian citizens trained in modern medicine were not accepted in this institution. Upset by this, nationalist citizens and doctors came together to propose the establishment of a medical college which encouraged trained Indian doctors on its staff. The doctors were led by Dr KN Bahadurji while Pherozshah Mehta from the Bombay Municipal corporation supported the idea; Gordhandas Sunderdas from the Jetha business family provided the main funds and George Witet, a British architect designed the buildings of both KEM Hospital and its affiliate the Gordhandas Sunderdas Medical College. Jivraj Mehta, a nationalist activist doctor, became its first Dean. Over the years, KEM and GS built up a formidable reputation largely due to the focus on both academic growth and service. Most medical institutions grow in this manner, one can argue. What was perhaps unique about KEM was the spirit of nationalism and the competitiveness with the British-run JJ Hospital, which meant that its staff went the extra mile. Its location in the working-class area of Parel meant it was firmly rooted amongst those who needed it the most. Post independence Mumbai's Municipal Corporation, one of the richest in the country, provided significant funding resulting in quick upgradation especially in the development of specialities. In a country with several underserved areas, KEM soon became a destination for patients from faraway places in the state and across the country. Though the Corporation later added two more big hospitals to the city, KEM remained the main referral hospital especially for complex problems, a reputation it still enjoys. Lakhs of aspiring medical students from across India choose the KEM-affiliated medical college GS as one of their top choices annually. It has had a tradition of robust research including some pathbreaking original research work. This included the discovery of a new drug Reserpine for hypertension by Rustom Jal Vakil, a cardiologist at KEM, and the rare 'Bombay' blood group by Dr Deshpande, a pathologist. KEM was also the first to attempt transplantation of the heart and liver in India and successfully set up a kidney transplant program. In 1986, Indira Hinduja, a KEM gynaecologist, delivered India's first test tube baby there. But KEM's leadership in research and innovation is increasingly under threat. A large majority of its postgraduate students and staff leave at some stage, either to go abroad or to join the private sector. One obvious reason for this is the lucrative emoluments in the private sector. However, the hierarchical system of the Municipal Corporation that oversees its functioning, ensures that only seniority remains the criterion for promotions is also not conducive to rewarding originality or extra effort especially for those who are at mid-career level. Either way this means that the dominant position of public institutions like KEM has eroded over the years. KEM now means different things to Mumbai's citizens depending on their social class. For the elite and the middle class, it is still sought-after to train their kids to become good doctors, or for their servant's healthcare needs. For the political class it's a symbolic trophy of a globally- recognised public institution they have inherited. For the poor, in spite of the delays, crowds and unhygienic conditions, it is still the place to seek decent, affordable healthcare. As are its neighbouring institutions like the Tata Memorial Hospital, Wadia Children's Hospital and the Veterinary Hospital, all of which occupy an oasis in the midst of a rapidly-gentrifying neighbourhood. Hundred years is indeed a landmark, but it is also a time for reflection. For example, what's the future of public institutions like KEM in the new India? Slowly abandoned by those who can afford the private sector and even by those who cannot. And yet, it continues to serve the poorest of the poor; patients with no option or voice. There is another dilemma: we must articulate the shortcomings of these institutions because that's the only way forward for change; but the more this is done, the more public trust is reduced, benefitting the private hospitals, in turn. KEM is also a metaphor for our history and collective future. The future of scientific medicine and publicly-funded institutions which are the only hope for the poor, and our collective progress. When I joined KEM as a starry-eyed MBBS student at 18, I had the same feeling of achievement and entitlement like thousands of students over the years. When I left at 40 as an Associate Professor in Surgery it was with a tinge of sadness and some disappointment. Now as I look back, I feel mixed emotions. On the one hand is huge pride in having been part of its formidable legacy, and on the other, is concern over KEM's valourisation as a public hospital has been reduced to symbolism, and my own complicity in its gradual abandonment....