Spend on health care first and then on disease care
We are not really afraid of typhoid, tuberculosis, leptospirosis, diabetes, HIV, malaria and a host of other infectious and non infectious diseases which are flourishing in our country. The apathy towards the basic issues in health care is really appalling. Why should we be afraid of swine flu alone? The medical profession is busy and happy treating diseases, confining to its own insulated and comfortable compartments. I happened to read with concern the comments made by s ome that we are not equipped to face the threat of swine flu, as if we are already well equipped to face the threat of all other communicable diseases; they go on to assert that the problems we face are due to lack of dedicated infectious disease departments and dearth of WHO-trained doctors in the medical colleges of Kerala.
A matter of approach
It is true that we need infectious disease units in each medical college, like the ones we already have; but the only problem is that we do not have an adequate number of doctors to spare to improve the services, to do research and surveillance.
The issue can be solved easily by posting a few more doctors for this purpose alone rather than hunting for WHO-trained doctors. Why not the existing system be made to tackle the problem by reorienting and reorganising than compartmentalising? In health care (no disease care), there is only doctor-oriented planning and implementation and no community-oriented planning.
A properly trained MBBS doctor or even an educated person with common sense and some training is more than enough to manage the threat of any public health issue. The general medicine department of any medical college can easily tackle all these if they have a few more doctors and isolation wards. We ignore health care and literally manufacture disease of all colour and shades, and finally we have a museum of all diseases. We have already become the diabetic capital of the world, and now we are trying to overtake Sub Saharan Africa to win the first place in the number of AIDS cases, malnutrition and environment-related infections, which produce more morbidity and mortality than swine flu.
The developed countries are worried since they have controlled all infections by proper waste management, safe drinking water and good nutrition for all and press the panic button the moment they come across any one of them.
They would have shown similar panic if typhoid, viral hepatitis, leptosirosis or TB occur in much lesser numbers than we see in India. Why are we not similarly worried about these diseases which kill several thousands annually? Let us not panic merely to show that we are also developed and evolved.
The basic issues
All communicable diseases are flourishing here because of lack of basic health amenities, malnutrition, poor environmental hygiene, unsafe drinking water, etc. People are now exposed to unchecked consumerist forces promoting lifestyle disorders with an even greater impact on us.
One more world environment day had passed — we behaved like the developed world by planting one or two trees here and there and having a talk on ozone layer and green house effect and that is it. We overlook environmental issues like poor waste management and unsafe drinking water everywhere.
We always ignore basic issues and go for knee-jerk reactions to appear big in front of developed countries. We need to do some homework and introspect and bring well-meaning leaders with a vision for the people on top of every system and make changes to achieve health and prosperity and then start panicking at problems like swine flu. We must try to achieve good environmental hygiene and provide safe drinking water for everyone.
We must prioritise and spend on health care first and then on disease care.
( The writer is Dean, Faculty of Medicine, University of Calicut )
There seems to be a tsunami in the medical field vis-À-vis the new swine flu, an insult to that poor animal! Every article and blog tells us about it but does not answer many questions. I think this is an opportunity to ask those questions. I am looking for answers, not knowing the answers myself.
Wisdom of Socrates
I had trepidation to write this response up until I read about educere, like what Socrates used to practise. There was no “authority” defined as we read in Theaetetus: (written by Plato in 360 BC translated by Benjamin Jowett) “Well, my art of midwifery is in most respects like theirs; but differs, in that I attend men and not women; and look after their souls when they are in labour, and not after their bodies: and the triumph of my art is in thoroughly examining whether the thought which the mind of the young man brings forth is a false idol or a noble and true birth. And like the mid-wives, I am barren, and the reproach which is often made against me, that I ask questions of others and have not the wit to answer them myself, is very just the reason is, that the god compels me to be a midwife, but does not allow me to bring forth. And therefore I am not myself at all wise, nor have I anything to show which is the invention or birth of my own soul, but those who converse with me profit.” Every medical student (and scientist) would do well to read this advice of Socrates.
Why was the WHO in such a great hurry to raise this to pandemic level? Why is it that the multiple-drug-resistant tuberculosis that could kill millions if left unchecked not a pandemic? Where is the controlled study to show the effect of Tamiflu against the new swine flu virus, in our evidence-based medical system? Has the new vaccine been tested against the virus in a large study? Is this vaccine safe to give to all age groups, especially when we are ignorant of its true validity?
Will the linear projection of large deaths due to the imaginary dread of the new virus materialise? Do the non-linear universe and the human body follow the linear laws? Do we not know that fear, especially of millions in the world, might weaken their immune system? Does the host resistance play any role in the final outcome of the fight between the virus and man? If so, why are we not doing something to build good resistance against the virus?
Why do we not accept similar untested, but inexpensive, remedies available in many other systems like the Chinese, the Indian Ayurvedic and homeopathic systems? Russian scientists have demonstrated viral (and other germs) destruction using particular frequency of subtle energy non-invasively! Our positive sciences understand only five per cent of the total energy in this universe while the large 95 per cent needs to be explored for common good. Why are all those efforts classified as pseudo science?
In the present scenario, it looks like science is what accepted scientists think it is! All these, and many more questions, beg more questions but answers! Educational system was changed by the Romans from educere of Socrates’ time to educare of today, where the authority prescribes what the students should learn from outside!
( The writer is retired Vice-Chancellor of the Manipal University )