Medical Problems prevalent in India

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DoctorMalki

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I thought we should talk about medical problems that prevail in india. what do you think causes them and what would you do to prevent them from occuring?
I guess I'll start.... :)
I worked in villages around delhi and one problem I found was the prevelance of jaundice and typhoid. The cause was unsanitary conditions and unhealthy drinking water... we tried several literacy projects and tried to educate the villagers about the problem and its solution.... we saw some amazing results. If I get a chance in medical school to do a study abroad project i would love to go to smaller villages that do not have health care accessible to them and educate them about medical conditions.

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DoctorMalki said:
I thought we should talk about medical problems that prevail in india. what do you think causes them and what would you do to prevent them from occuring?
I guess I'll start.... :)
I worked in villages around delhi and one problem I found was the prevelance of jaundice and typhoid. The cause was unsanitary conditions and unhealthy drinking water... we tried several literacy projects and tried to educate the villagers about the problem and its solution.... we saw some amazing results. If I get a chance in medical school to do a study abroad project i would love to go to smaller villages that do not have health care accessible to them and educate them about medical conditions.
Ask me..have stayed in India for 15 yrs...
I think the main problem in India is clean drinking water and pollution that has led to innumerable # of diseases and in addition in many villages poeple dont have no access to nearby health care .They have to go distant places even just for a regular practitioner.
 
I am under the impression that leprosy, TB, and especially AIDS are a major problem still.

Of course with AIDS being a major problem everywhere, I don't expect India to be at the forefront of irradication. However, TB and leprosy should be *somewhat* easy to overcome.

I am Indian and proud of it. However, the one thing that gets me is that I honestly don't think that India will ever evolve out of its current status as an over-crowded and relatively poor nation :(
 
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desikudi said:
Ask me..have stayed in India for 15 yrs...
I think the main problem in India is clean drinking water and pollution that has led to innumerable # of diseases and in addition in many villages poeple dont have no access to nearby health care .They have to go distant places even just for a regular practitioner.

I definately agree with the issue of their not being enough physicians... medical schools in india are coming up with a new policy that the recent graduates have to serve a couple of years in villages that are underserved and need health care so I hope that helps a little.
 
Buckeye(OH) said:
I am under the impression that leprosy, TB, and especially AIDS are a major problem still.

Of course with AIDS being a major problem everywhere, I don't expect India to be at the forefront of irradication. However, TB and leprosy should be *somewhat* easy to overcome.

I am Indian and proud of it. However, the one thing that gets me is that I honestly don't think that India will ever evolve out of its current status as an over-crowded and relatively poor nation :(


I doubt the indian healthcare situation is going to get any better until the politicians and government are corrupted. Social work groups are trying to help the underserved and poor people in india but they can only do so much. India needs a lot of help and intervention from the government. A new project ( not that new maybe 10-15 years old) is getting children vaccinated for polio. It is an all india campaign they are doing so hopefully that will help with the huge prevalence of polio in india.
 
Hi people, this is a very good thread Dr. Malki. I think the basic problem of Diseases within India can be divided into two main categories.

Water Borne diseases. Other communicable Diseases.

In Frequency, water borne diseases as a collective is by far the greatest threat particularly to children.

Within other communicable diseases, HIV is by far the greatest threat.

The factors compounding this threat according to me are as follows:
1. Lack of infra structure. By this I mean the span of water drainage especially after the monsoon to the lack of availibility of running water in neighborhoods literally feet away from major cities. Water management is a concept that is unfortunatley a mystery to us. If this is to be developed not only will the occurance of water borne diseases decrease, but also the dreaded "drought" would be a thing of the past. The immunization coverage is getting better. Roads, rails power availibility etc in the rural areas are very imp for this since vaccines are extremely temp sensitive.... nonetheless all issues with infrastructure.

2. Lack of education. The general public has to be educated more. Although this is something that is better handled than say Africa it is still a problem. Local orthodox culture is a compounding factor to this problem. The orthodox muslim population in MP, Bihar and Rajesthan refuse to send female children to school. Campaigning against that becomes an attack against islam and riots follow (this is just an example, Hindus also have big problems especially with sex education).

There are many other factors but these are the greatest.

I do see things getting better. With the new influx of wealth, booming interest within foreign investors, our mastery of information technology and pharmaceutical technology and most importantly stability of the nation (as opposed to civil war which plagues the entire african continent) we are in a much better position to handle public health matters.
*most of my information comes from the UNICEF and WHO literature and from my pops who has been a communicable disease specialist with these two NGO's for over 25 years.
I just hope some of you out there will take an interest in this matter an provide support to the cause not only through financial donations but donation of time and your expertise of medicine.

*gets of soap box*
 
Also let us not forget that the indigent people from non developed parts of the country seem to have a strong voice.... I mean they did manage to keep the mighty BJP from regaining office.
This means that every administration will now understand that they are not immune by overfeeding the rich while sticking it to the poor.
 
DoctorMalki said:
I definately agree with the issue of their not being enough physicians... medical schools in india are coming up with a new policy that the recent graduates have to serve a couple of years in villages that are underserved and need health care so I hope that helps a little.
yeah..thats a good policy but still ,due to politics many students dont exactly follow this policy..i know and have heard of many who tranferred to urban areas within 1 month of their duty in rural area.
 
great posts AMMD.

Definitely a lot needs to be done and I see lack of infrastrucuture as the biggest problem.
 
Great response AMMD.

I definitely agree that communicable disease and food/waterborne disease is of the greatest concern.
My passion for work is in HIV/AIDS prevention and I do my best to keep up with the HIV/AIDS situation in India. It kills me to see how rapidly it has taken over in India. The WHO estimates that in 10 yrs, the rates will be similar to those of S. Africa. That is unbelievable. When this report first came out, I remember watching an interview of some indian gov't official saying that those numbers are overly exaggerated and that the situation is not that critical!!! I could not believe it. That is the first problem right there. India needs to first admit that there is a problem before they can address the needs of the population! It also doesn't help matters when we come from a very "hush hush can't talk about sex" culture. There is also, as is all over the world, a great negative stigma associated with HIV/AIDS, which greatly affects the access to care for those needing medical attention.
If anyone is interested....check out http://hrw.org/reports/2004/india0704/
The entire website is great, but this one link in particular was very moving. It always has an affect when you look at the devestation this causes to the children.
There is soo much potential for the situation in India. I do see it getting better.
 
I agree that communicable/waterborne diseases are a big issue. But over the years there have been programs to address that. These programs haven't solved the problem but are definitely improving the situation. Unfortunately, just as India is starting to catch up the HIV crisis is affecting people very quickly. For financial and cultural reasons the HIV crisis is not being addressed aggressively enough. I believe in the future that will be a much greater health concern for India.

Another health related topic that may be of interest to you guys is selective abortions. This is more of a social problem, but the medical community does play an important role. I know for a fact the Female to Male sex ratio is skewed all over India but particularly in north India in areas where more technology and health care options are available. I believe the ratio was almost 800 females for every 1000 males in Punjab and Delhi. Of course, ultrasounds for sex determination and sex-selective abortions are illegal in India (not to mention immoral by any religious standard), yet they happen all the time. This seems really wrong to me. But it could be looked as natural / inevitable. There's a law (i can't remember what its called) but it states that war and disease are natural and necessary to keep limited resources available for an adequately sized population. Women have had it bad for centuries. As the supply goes down and demand goes up, may be they'll be treated better.

A large part of this problem I think is the social stigma of having too many daughters, paying for their dowries, and the belief that one MUST have at least one son. But healthcare professionals could prevent some of this by justing holding themselves up to a higher ethical standard.

Back to the point of the thread:
Most of the problems can be prevented by good preventive care, health education and proper sanitaton. But the really contentious question is if treatment/prevention and thus saving more people is really the answer for a country like India?
I don't really have an answer but I wonder about these issues often. Just curious to see what you guys' thought are.
 
Nice guys, I ve not replied to this topic as yet because I knew I would go on and on..and the given time constraints..
Indeed a very interesting topic. I've lived in India for most of my life and have come to a certain conclusion.
This is how its logistics goes:
1897-1947
-Indian population not well educated.
-India has all raw sources which were plundered. With the help of all this natural wealth, once educated, the indian population could have used these resources more efficiently.
-Resources, Energy and Skills of learned people were spent in fighting the British, which could have been used instead for making people aware of the importance of education at the same time educate them and thereby fight poverty. We were fighting constantly for 50 years.
-Even before the British came to India, efforts were being made to encourage woman-education, so imagine how well that could have worked if it was not for the British.
-Our leaders like jawaharlal Nehru, Shubhash chandra Bose, et al knew english so I think spreading education in english wouldn't have been a problem, if people think that had it not been for the british rule we would not have been able to communicate in english.
-Okay, assuming we never started and starved as such poor people for 50 years we would have been richer in 1947 itself, but we were poorer then because we were looted.
-Its 2004 right now, we can only imagine how much progress we could have made.
-There would be less poverty, more education. RIght now we are the # 1 country to which tech labor is outsourced.
-Unfortunately some part of the population has not got a chance to educate themselves since the British Rule ended, because the Government does not direct its economy in the right manner.
-For example, taking the simplest case for that matter- when a donation is made to the indian government, it does not reach the appropriate places. Its eaten away by the middle men.
- Its not a new problem in India that the richer get richer and the poorer get poorer. The middle class is the working people who somehow managed to educate themselves and get themselves jobs.
- For all these reasons, I have had this thought in my mind that when the NRI doctors from the US think of making a donation, I think they should themselves go to the poor population and help them out by actually what they need. Indian poor population (slum people) have a bad tendency of using that money for anything, but buying themselves clothes, food or house. SO they prefer to live like that.
- For example, when the construction people want to build a building in a certain place which is occupied by slums, the builders offer to offer those people a house in their newly constructed building so that they can get the slums out of the place. nevertheless, those people prefer to take money then live in a nice house and hygiene.
- So the problem is not as simple as it may seem. Sometimes it feels like the problems are going to be stagnant unless and until each person is educated. COnsidering that the population of india is increasing at a sky rocketing rate I am not sure how successfully this grass root problem can be solved.
- There's one solution, If all the NRIs themselves and by appointing volunteers educate the people basically first of all about protected sex and HIV( they hardly care about HIV, because they might prefer to die after having thier share of pleasures rather than starving away without HIV + supporting kids for the rest of their lives..)
- One thing is for sure...NRIs should , "NEVER DONATE TO AN ORGANIZATION" because there is a lot of controversy going on and you never know that your money is actually doing good, you basically just wasted your money and did you feel that your purpose of "donating" is achieved but it reallly isnt.

According to me, since I belong to Indian culture and born there, it is my moral responsibility to do everything for India that I can. Its just like, with all the good you recieve from the culture, it feels nice to give back something too...
I :love: India :D
 
priyanka said:
According to me, since I belong to Indian culture and born there, it is my moral responsibility to do everything for India that I can. Its just like, with all the good you recieve from the culture, it feels nice to give back something too...
I :love: India :D

interesting post. I salute you ;)
 
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Premedtomed said:
interesting post. I salute you ;)


So DO I :), not for saluting me, but for the fact that people salute only those people who endure something very dear to themselves. Tells me how much patriotism and India means to you, which is very nice to know... I think people become more patriotic after moving abroad,atleast in my case...

oh by the way,...do you know who Siddharth was? I wish I had attained the discipline that he had attained.
also, get out of kentucky for med school! ;)
er

Oh well! am gonna be out for sometime so no SDN for me..so dont mind if i dont reply to a question addressed to me....I ll see you guys after some days!! :)
pri
 
priyanka said:
So DO I :), not for saluting me, but for the fact that people salute only those people who endure something very dear to themselves. Tells me how much patriotism and India means to you, which is very nice to know... I think people become more patriotic after moving abroad,atleast in my case...

oh by the way,...do you know who Siddharth was? I wish I had attained the discipline that he had attained.
also, get out of kentucky for med school! ;)
er

Oh well! am gonna be out for sometime so no SDN for me..so dont mind if i dont reply to a question addressed to me....I ll see you guys after some days!! :)
pri
that is so true ,priyanka.I fell the imp of everything of india,only after i came here. :love: missing India.
 
AMMD said:
Hi people, this is a very good thread Dr. Malki. I think the basic problem of Diseases within India can be divided into two main categories.

Water Borne diseases. Other communicable Diseases.

In Frequency, water borne diseases as a collective is by far the greatest threat particularly to children.

Within other communicable diseases, HIV is by far the greatest threat.

The factors compounding this threat according to me are as follows:
1. Lack of infra structure. By this I mean the span of water drainage especially after the monsoon to the lack of availibility of running water in neighborhoods literally feet away from major cities. Water management is a concept that is unfortunatley a mystery to us. If this is to be developed not only will the occurance of water borne diseases decrease, but also the dreaded "drought" would be a thing of the past. The immunization coverage is getting better. Roads, rails power availibility etc in the rural areas are very imp for this since vaccines are extremely temp sensitive.... nonetheless all issues with infrastructure.

2. Lack of education. The general public has to be educated more. Although this is something that is better handled than say Africa it is still a problem. Local orthodox culture is a compounding factor to this problem. The orthodox muslim population in MP, Bihar and Rajesthan refuse to send female children to school. Campaigning against that becomes an attack against islam and riots follow (this is just an example, Hindus also have big problems especially with sex education).

There are many other factors but these are the greatest.

I do see things getting better. With the new influx of wealth, booming interest within foreign investors, our mastery of information technology and pharmaceutical technology and most importantly stability of the nation (as opposed to civil war which plagues the entire african continent) we are in a much better position to handle public health matters.
*most of my information comes from the UNICEF and WHO literature and from my pops who has been a communicable disease specialist with these two NGO's for over 25 years.
I just hope some of you out there will take an interest in this matter an provide support to the cause not only through financial donations but donation of time and your expertise of medicine.

*gets of soap box*


Great Post AMMD !! A major problem is education. The project I was involved with in India targeted that problem where we went to villages and talked to them about diseases, prevention methods and hygeine.. simple things like washing your hands before eating and taking a shower everyday. A lot of these villages don't have a regular water supply either. It really sucks how the richer are getting richer and the poor are getting poorer. Many villages have stagnant water and during monsoons malaria is very wide spread. Education is a major problem and will take years to get better.
 
apgmph said:
Great response AMMD.

I definitely agree that communicable disease and food/waterborne disease is of the greatest concern.
My passion for work is in HIV/AIDS prevention and I do my best to keep up with the HIV/AIDS situation in India. It kills me to see how rapidly it has taken over in India. The WHO estimates that in 10 yrs, the rates will be similar to those of S. Africa. That is unbelievable. When this report first came out, I remember watching an interview of some indian gov't official saying that those numbers are overly exaggerated and that the situation is not that critical!!! I could not believe it. That is the first problem right there. India needs to first admit that there is a problem before they can address the needs of the population! It also doesn't help matters when we come from a very "hush hush can't talk about sex" culture. There is also, as is all over the world, a great negative stigma associated with HIV/AIDS, which greatly affects the access to care for those needing medical attention.
If anyone is interested....check out http://hrw.org/reports/2004/india0704/
The entire website is great, but this one link in particular was very moving. It always has an affect when you look at the devestation this causes to the children.
There is soo much potential for the situation in India. I do see it getting better.

good point... the stigma of HIV/AIDS is definately in everyone's head in India. People don't want to get treated for it because then they think that no one will want to associate with them. Again it comes back to education, many still think that by touching a patient with HIV or talking to them you will get AIDS. I saw this movie phir milenge about a life of an AIDS patient.. even though I am nto a big fan of salman khan the movie briought up some pretty important issues that I think persist in India. What do you think is the major cause of the spread of AIDS in India ?
 
DoctorMalki said:
good point... the stigma of HIV/AIDS is definately in everyone's head in India. People don't want to get treated for it because then they think that no one will want to associate with them. Again it comes back to education, many still think that by touching a patient with HIV or talking to them you will get AIDS. I saw this movie phir milenge about a life of an AIDS patient.. even though I am nto a big fan of salman khan the movie briought up some pretty important issues that I think persist in India. What do you think is the major cause of the spread of AIDS in India ?

I think it's a slew of factors such as:

1. Lack of education about the disease and thus very little to no practical knowledge of its prevention and management.

2. Lack of control over one's sexuality; this is particularly relevant to women, who are often unable to assert control in their sexual relationships.

3. Lack of protective materials. Let's face it: people are going to have sex. In light of this, the pertinent question is one of procuring protection. In the case of the extremely poor, it's very difficult to justify the expense of a condom when you would rather spend that money satiating an empty belly.

4. Possible cognitive barriers, such as the belief that life can't possibly get worse than it is now; living in slums can breed this sort of mentality.

5. Socio-cognitive barriers are also potent. Stigma associated with an infection that is not readily understood can lead to a lack of communication and openness regarding the disease. Understandably, not many want to share the fact that they may be infected due to stigma.

6. Promiscuous sexual behaviour, particuarly between males. This is a controversial issue, but recent sexuality studies have suggested that since homosexuality is frowned upon in India, many gay men choose to marry, while continuing to carry on extraneous relationships on the side. There is the risk of transmission of an infection between husband and wife, with the latter never even having any awareness of the disease until symptoms arise.

7. Sex trade. Because there is no way to legislate this "vocation" in a country as large as India, countless innocents who are initiated into this track in life never have the opportunity to live out their potential.

Sorry I do not have the time to elaborate any further. :cool:
 
H2O said:
I think it's a slew of factors such as:

1. Lack of education about the disease and thus very little to no practical knowledge of its prevention and management.

2. Lack of control over one's sexuality; this is particularly relevant to women, who are often unable to assert control in their sexual relationships.

3. Lack of protective materials. Let's face it: people are going to have sex. In light of this, the pertinent question is one of procuring protection. In the case of the extremely poor, it's very difficult to justify the expense of a condom when you would rather spend that money satiating an empty belly.

4. Possible cognitive barriers, such as the belief that life can't possibly get worse than it is now; living in slums can breed this sort of mentality.

5. Socio-cognitive barriers are also potent. Stigma associated with an infection that is not readily understood can lead to a lack of communication and openness regarding the disease. Understandably, not many want to share the fact that they may be infected due to stigma.

6. Promiscuous sexual behaviour, particuarly between males. This is a controversial issue, but recent sexuality studies have suggested that since homosexuality is frowned upon in India, many gay men choose to marry, while continuing to carry on extraneous relationships on the side. There is the risk of transmission of an infection between husband and wife, with the latter never even having any awareness of the disease until symptoms arise.

7. Sex trade. Because there is no way to legislate this "vocation" in a country as large as India, countless innocents who are initiated into this track in life never have the opportunity to live out their potential.

Sorry I do not have the time to elaborate any further. :cool:

Thank H2O ! You bring up several good points that I never thought about such as the stigma causing gay men to marry women and then still carry on affairs on the side.
 
esecallum said:

thanks for that post esecallum.... I had no idea you could possibly do this. If this is such a success then why is it not a popular method of choice for treating such diseases? Why is the current system letting people die from malaria and AIDS and not use this machine they have at their disposal?
 
aww nice topic!!! :)
 
DoctorMalki said:
thanks for that post esecallum.... I had no idea you could possibly do this. If this is such a success then why is it not a popular method of choice for treating such diseases? Why is the current system letting people die from malaria and AIDS and not use this machine they have at their disposal?

thanks for replying dr malki.

the answer to your question is very simple:-

Money.

no money can be made from this but more importantly this would compete DIRECTLY with pharmaceutical drug profits which would be decimated if widespread use was made of it.

In western countries jobs,the economy and taxes depend on these very profitable industries.

think of the millions that were spent on these patented drugs by pharmaceutical companies on research and marketing and the vast profits.

if you were the owener of a pharmaceutical company would you permit this?
would you not use your power and influence to protect your profits?


thats is why i posted it here as this is very suitable for poorer countries.

just think a single machine treating hundreds and thousands of people over and over again.the cost per patient being negligible....

The devices can be made very easily and full instructions are provided in the links within the link.

now compare that to pharmaceutical drugs which have to be ingested and are consumables and expensive for poor countries and many have toxic side effects.Also drug resistant malaria is becoming a huge problem.


i suggest you read the malaria study again.after 3 days of 1 hour daily blood electrification a lot of the trial study patients did not return as they felt much better.


The devices are very easy to make and i strongly urge you to get some bright open minded biophysics students group to build the devices,do further tests if required and implement it in Africa/India.I cannot emphasise enough the low cost and the lack of side effects.

i suggest you save the webpage and preserve the important links in it.


You will meet resistance from the establishment and those who produce anti-malaria and Aids drugs.

i also have a different very low cost Aids cure but i will post that next week as i dont want to be accused of spamming the board.

when you read about this Aids cure you will be astounded as to why its not been implemented.Its extremely detailed and was clinically tested on 3 patients and an animal with great success.

again its extremly low cost and can be mass produced and re-used.

once again my only motivation is to save lives and I strongly urge you to do as i asked above.
 
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