Help Others to Help Yourself

So much for a vision of what a healthy society should be. As an individual, what you can do to improve your community's health is to participate actively and to volunteer your services in various fields: for example, as a guide in hospitals; to lobby against polluting industries; or to care for older citizens. Improving a community's health can be the entry point for improving the quality of life for the entire community! Remember, that by helping to improve the health of the community, you are helping yourself and your children!

Health Community

A healthy community looks after the health of all its members, including the underprivileged. It protects the rights of the disabled and treats them respectfully as individuals who are 'differently abled', and also develops active programs for preventing and treating drug abuse and alcohol abuse. Progressive communities also provide hotlines for suicide prevention as well as counseling, so that people have someone to reach out to and talk to.

Individual Initiative

All political action, however, starts with an individual's initiative. Doctors in India constantly complain about the shortage of safe blood banks. Isn't this state of affairs tragic in an overpopulated country like India (where one would imagine that there would be no shortage of people willing to donate blood). When was the last time you donated blood? If we do not develop a social conscience, we will not be able to improve our community's health, and we will all pay the price sooner than later.

Eradicating the root cause

We still continue to take a piecemeal approach to treating disease on a case-by-case basis, but this approach is doomed to fail in the long run. Let's take the example of bronchitis. At present, we treat only those individuals who are suffering from the disease. However, a social approach to treating bronchitis would focus on removing those factors in the environment which are known to cause or aggravate bronchitis, such as air pollution, poor working conditions, industrial pollution and cigarette smoking. While the modern medical system is designed to look after ill patients, we cannot improve the health of our community without taking concerted political action!

ILL Health Care System

The entire health care system is ill! It concentrates on treating the sick, but does little to prevent them from becoming so. In fact the term 'health care' system takes care only of the sick. It treats only individuals, but does not attack the basic causes of illnesses, such as poverty and illiteracy. Far from encouraging people to lead healthy lives, our society encourages them to harm themselves, and a prime example is cigarette smoking. Unfortunately, profits come before people --- and there are too many people making too much money from tobacco, so that the tobacco industry continues to spend billions a year encouraging people to smoke, and the government allows them to do so. The question is: what sort of society lets a small group of people persuade the masses to engage in behavior which might kill them --- and then provides medical care to try to save them?

Political problems need political solutions

Political problems need political solutions, but governments in India have done precious little for providing health care for the common man. They make grandiose plans for a primary health centre in each village, but typically these PHCs have no medicines or supplies, because they have been siphoned off. They build expensive super specialty hospitals in cities, but most of these just end up as a palace of diseases, while the poor continue to die without food and shelter.

Origins of Illnesses in different sections of society

Keeping in mind all the foregoing factors, we simply cannot afford to continue to live in our own shells! In the final analysis, health is a political matter, and the types of illnesses found in society are reflection of the nature of that society. Illnesses do not hit all groups in society randomly and equally, and just as wealth is unequally distributed in Indian society, so is ill health. One of the best predictors of a person's life expectancy is his annual income and extensive research has proven that many illnesses have their origins in social conditions. The difference starts right from childhood, and poor nutrition means that the children of the poor are shorter, weaker, sicker and thinner than those of the rich --- even at birth.

Although an individual's life expectancy has increased, the gap in life expectancy between the poor and the rich has also continued to increase all over the world. According to a survey of global health by the World Health Organization, poverty was the greatest underlying cause of disease, leaving many with inadequate access to nutrition, drugs and basic health care. Those living in poverty must focus on survival priorities and often don't have the time or the energy to prevent or treat illnesses, until they are forced to. Leading a hand-to-mouth existence means falling ill is a luxury they really cannot afford! Unfortunately, many doctors and hospitals fail to treat the poor as well as they would treat the rich, so that many simply avoid doctors and hospitals completely because of inferior care.

Prevalence of illness

The prevalence of illness is increasing rapidly in metropolises such as Mumbai and Delhi. This increase can be attributed primarily to overpopulation, poor sanitation and excessive pollution. Water- and food-borne diseases are endemic, and these diarrheal diseases have been the major killers, especially of children. Also, respiratory diseases (such as asthma and bronchitis) are beginning to pose an equally serious threat to life because of increasing levels of air pollution.

Effects of toxins

Effects of other toxins may be more subtle and hormone disrupters (such as industrial estrogenic chemicals) have been shown to decrease sperm counts in men all over the world! Living safely in a polluted world is no easy task, and is likely to become increasingly difficult for our children, as these toxic accumulate agents can in the environment over decades.

Occupational exposure to toxic chemicals

Occupational exposure to toxic chemicals is also becoming increasingly common. However, the risk of exposure to these chemicals is no longer restricted to factory workers alone. The 1984 Bhopal gas tragedy is an outstanding example of how thousands were adversely affected because of the failure to implement simple precautions, even though the factory from which the deadly fumes emanated was dealing with toxic chemicals. The Bhopal tragedy is replayed almost daily on a much smaller scale in cities all over India; for instance, when a tanker carrying toxic chemicals overturns and releases its poisonous load into the environment, or when manufacturing units operating from residential areas spew out toxic waste products.

Environmental health hazards

The number of environmental health hazards is increasing daily. All of us are paying the price for industrial pollution. The 'litany of woes' is a long one! For instance: pesticides in our food; pollutants in the water; toxic fumes in the atmosphere; and harmful hormones in the milk we give our children to drink. We are bombarded by noise pollution daily which can cause numerous health hazards, including headaches, insomnia and hearing loss. People living in cities spend over 80 per cent of their time indoors, and indoor air pollutants can pose many health risks, including an illness called the 'sick building syndrome'!

Aware Citizens of Developed Countries

Citizens in developed countries of the world, have realized the menace of the problems created by unhygienic conditions and have collected together to lobby for change, in order to ensure healthy living conditions for themselves and their families. For example, environmental pollution affects the health of everyone, and you cannot afford to neglect the fact that the air you breathe is going to contain more and more toxic matter as the days roll by. Similarly, while it is the municipal corporation's responsibility to provide us with clean drinking water and to dispose off garbage hygienically, we should also ensure that this job gets done!

Developments for a healthy environment

A promising recent development is the fact that builders are realizing the importance of providing a healthy environment and many of them are now developing self-contained mini-townships, which provide all basic amenities within their four walls. These townships can be healthy places to live and bring up a family in, since they provide several essential features such as:

1. lots of open space to play in
2. clubs and gymnasiums to remain fit and healthy
3. shopping arcades
4. food markets
5. chemists' shops
6. Clinics and hospitals

However, while the quality of life is excellent for the residents of these townships, who form a privileged minority, what about the rest of the citizens? After all, if your domestic help and his/her family are going to live amidst filth, it's likely they will be afflicted by infectious diseases such as tuberculosis and typhoid, which they could then transmit to you and your family. In the final analysis, this is a problem which affects all of us and we simply cannot afford to turn a blind eye to it! However, since it is a public health problem, we are usually content to let the government tackle it - which it fails to do in its usual characteristic fashion!

The connection between health and cleanliness

The connection between health and cleanliness had been recognized and respected even in ancient India.

In order to remain healthy, a community must ensure the following:

* A regular supply of clean drinking water.
* Enough water for cleaning, bathing and washing clothes as well as for flushing toilets.
* Safe garbage disposal.
* Safe sanitation facilities.
* Clean pure air to breathe.

Unfortunately, virtually all over India, especially in the cities, the foregoing basic requirements are becoming the exception rather than the norm. While political action is needed to ensure that the government supplies these basic amenities, there is little concerted action taken by most citizens, with the result that the situation is likely to deteriorate from bad to worse. Taking care of the environment is a key part of remaining healthy, and if the community is not healthy, it is difficult for an individual to remain healthy.

The Healthy Community: One for All, All for One

No man is an island and just keeping oneself healthy is not enough. We all live in society, but most of us still neglect the importance of ensuring healthy surroundings, so that it's common to find a house which is clean and sparkling inside, with all the garbage tossed outside the door or window! However, all of us pay the price for dirty and unhygienic surroundings, as pernicious diseases such as cholera, malaria, typhoid fever and asthma flourish under filthy conditions. Ultimately, every locality needs to take action to keep its environment clean, and people need to realize that garbage and filth in the neighborhood threatens them directly in their own homes, through a proliferation of flies, cockroaches and mice. The need for preventive action outside the home (using garbage bins, keeping public toilets clean and keeping drains clear) is as important as preventive action inside the home (washing hands and feet thoroughly, washing vegetables properly, storing food safely, sweeping and swabbing the floor). It may be very difficult to organize the community, but if you do not, you may have to pay the price in the long run, by falling prey to a variety of diseases.

The combined knowledge of both old and new healing modalities

The combined knowledge of both old and new healing modalities is ultimately superior than a single-model approach to health and well-being. After all, no system of medicine can claim to have a monopoly on knowledge! What is needed today is a clinically responsible balance between the science of modern medicine and the comfort of alternative medicine. We need to combine the best of both worlds, much like fusion music does, and physicians from both sides can learn from each other! If Indian doctors are willing to blend an open mind with the scientific discipline which is needed for rigorous research, given our immense patient population and rich traditional medical knowledge base, they can become world leaders in providing the best medical care to their patients.

Diverse Alternative Therapies

Diverse modalities such as massage, Reiki, yoga, ayurveda, acupressure, hypnosis, homeopathy, naturopathy and many others can work in conjunction with each other as part of a unified team rather than in competition. We need to learn to combine the best of both worlds - high technology with high touch - and this is called integrative medicine, as pioneered by Dr Andrew Weil of the USA. Integrative medicine neither rejects conventional medicine nor embraces alternative medicine uncritically - just because most alternative medicine systems are 'natural' does not automatically make them better! For example, for emergency care in the case of acute medical problems such as a fracture, Western medicine is still the best bet. However, for chronic diseases such as arthritis, asthma, angina and hypertension, alternative medicine may offer a better choice for some patients. The most important requirement is that you need to find a good doctor, no matter what system of medicine you choose to follow. It is equally important that you understand the limits and the rationale of the system, so that you are not taken for a ride. Thus, if an ayurvedic doctor prescribes antibiotics, you should begin worrying!

Alternative medical systems

One of the reasons for this sorry state of affairs is that alternative medical systems receive little official support and minimal funding. The situation often deteriorates into a conventional versus alternative medicine confrontation, with each system belittling the other, and this is a real tragedy. By ignoring alternative systems, doctors may be depriving patients of better medical treatment options. We need to remember that all doctors are on the same side - all of us want our patients to get better, no matter what system of medicine we practice!

Alternative medicine practitioners

Alternative medicine practitioners need to be made accountable for their actions to ensure that they are up to date with their education. Also, some type of peer review mechanism needs to be put in place to ensure the safety of the public. Otherwise, the danger is that medicine can become a 'bastardised' system (for example, homeopathic practitioners in India who prescribe allopathic antibiotics for coughs and colds) which can harm patients considerably.

Practice of alternative medicine in India today leaves a lot to be desired

For one, such medicine does not have a universally accepted scientific basis; hence, it is difficult to rigorously analyze its claims. Since there is no need for formal publication or peer review in alternative systems of medicine, there is little scientific documentation available about their efficacy or side-effects, so that it becomes difficult to confirm claims or dispute them. Consequently, one has to blindly trust the doctor. Authoritative journals or texts are difficult to find; and most publications use little scientific rigour, being based mostly on anecdotal case reports, with little documentation or proof. Moreover, since there is no official monitoring of the practitioners of alternative medicine, anyone can make tall claims and get away with them! Also, since there are few formal training requirements, anyone can practice alternative medicine, with minimal skills or qualifications. Unfortunately, unscrupulous practitioners have mushroomed, who are out to make a quick buck, and malpractice's and quackery flourish.

Difference between alternative and complementary therapies

Since alternative treatments are used instead of conventional regimens, they can be medically dangerous and can delay standard medical care. Complementary therapies, on the other hand, are used in conjunction with mainstream treatment and are much more common. Complementary therapies become alternative only when promoted as 'stand-alone' remedies for serious illnesses. It is not the therapy itself, but its goal or the intention behind its use, that defines a regimen as alternative versus complementary.

Putting Patients First (PPF) Community@HELP

Introducing a Monthly Patient Community Meetings at HELP Library:

PUTTING PATIENTS FIRST (PPF) COMMUNITY @ HELP

Goal: To provide a platform for patients and health care providers to connect.

Get Involved

Whether you are a medical student, a physician, a health care provider, a patient or a
community member, there are many ways for you to become involved in the project.
Take a workshop, become a community educator, become a sponsor, volunteer your time
to help us plan an activity or become an advocate for the project!

Interested ? Please contact Ms.Anjoo Chandiramani - email: helplibrary@gmail.com
Tel Nos: 22031133/22061101