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Healthcare And Disease - The Current Challenges In India

Healthcare And Disease - The Current Challenges In India

Posted By Rupa Jaiswal Posted on Jan 14, 2022

Saffron for Courage, White for Peace and Green for Prosperity... shouldn't the virtues signified by our Tiranga percolate into our daily lives too, especially pertaining to our health? Courage to undergo that testing and confront head-on whatever may come, Peace of mind after gaining an insight into our overall health status and prosperity in life with the assurance of good health. But can we say with supreme confidence that these expectations which are also the rights of each citizen are being fulfilled in our Country? There are certain diseases and health conditions that are more prevalent in India than other nations. This is due to a variety of factors which include social, economic and financial issues. These issues are responsible for several diseases and/or health conditions to prominently rise in our nation. A big step towards addressing these issues is more important than ever to achieve good health of our citizens. BASIC SANITATION is also major cause of diseases.

Healthcare And Disease - The Current Challenges In India

Sanitation issues pose a big burden on healthcare, and hence evaluating different remedial measures along with their affordability, purpose and long-term benefits to the society at large needs to be considered. Weighing different options to deal with human wastes like on-site or off-site disposal, sewage treatment measures, etc. should be set depending on the density of population and other social and geographic factors. Good sanitation is the basic need for a society and to develop a healthy country. Simple measures taken can compound healthy benefits at large. Sustainable growth and expansion will only become a possibility when sanitation measures become considered as the foremost pedestal to tackle.

What involves basic sanitation?
Before we try to list down the various criteria that fall under basic sanitation, it is important to understand and define 'sanitation accurately. The definition of sanitation is dynamic and is often defined on the basis of priority issues and problems being faced pertaining to sanitation. To summarise, the colossal idea behind sanitation, it may be said to involve:

Safe and logical collection of human wastes, their proper treatment and disposal or recycling (recycling would majorly involve human urine and faeces)

Management/recycling/reuse of solid wastes and sullage from human settlements

Collection and proper management of industrial waste products

Disposal, reuse/recycling of sewage effluents

Management and proper disposal of hazardous wastes generated by hospitals, chemical and radioactive wastes, etc.

Why Sanitation has to be focused on?
Needless to say wherever humans are, the amount of waste generated will be huge. Though a lot of progress is being made in meeting efficient sanitation, many areas and people lack to find proper means to dispose of wastes. Non-effective management strategies of wastes, especially in heavily populated areas eventually lead to an increase in risk towards many infectious diseases and epidemics. Such conditions majorly end up targetting the young, elderly generations or individuals with low resistance power towards fighting diseases. Again, poor management of wastes too contributes in making the surroundings unpleasant eventually putting even other species at risk affecting the ecological balance. The major routes that are directly affected due to poor sanitation include:

Drinking water

Food chain which majorly involves sites used for growing fruits, vegetables and breeding of animals for their meat and fishes Recreational sites, etc.

Communicable Vs Non-communicable
Communicable ailments include the infectious conditions which if not controlled have the potential to become epidemics posing a major threat to human life and colossal burden to the healthcare system. The one fundamental threat for the aforementioned calamity is sanitation conditions. Non-communicable ailments though have risen to epidemic proportions in our country today, majorly caused due to lifestyle habits and geneties, it is the communicable ones which can be completely eradicated with appropriate and monitored sanitation measures in place.

Poor sanitation = Healthcare in distress
Poor or no sanitation in human settlements is an ideal opportunity for spread of many infections. In fact, human excreta alone have been involved in transmission of diseases such as typhoid, cholera, hepatitis, ascariasis, etc. and even encephalitis. Estimates by WHO prove that diarrheal diseases alone caused due to poor sanitation are a major responsible factor for deaths among children less than 5 years of age.

Among parasitic diseases, malaria holds the first rank with the affected regions showing poor or no sanitation and is majorly a concern in tropical and subtropical regions of the world. Conditions like ascariasis is found almost worldwide having greatest frequency again in tropical and subtropical regions affecting more of the areas with less sanitation. Ascariasis also contributes to be the major chunk of intestinal worms infection in the developing regions of the world.

Yet another parasitic infection prevalent in many developing areas more precisely in Asian countries is that of Trematodes. Flatworm infections mostly spread through fecal contamination, as the larvae are present in the faeces of an infected individual. Trematode infections enter the food chain through fish, shellfish and finally into humans. Global estimations of WHO prove almost 10% of the population to be at risk.

Another leading cause of preventable blindness - trachoma infection is again linked to poor sanitation! Again to add to the misery, it is the sole reason for making almost 6 million people around the globe permanently blind. This contribution of trachoma infections in causing preventable blindness is majorly supported by poor sanitation, substandard hygiene related to drinking water, etc.

Besides being the major cause for spread of infectious diseases, adverse conditions fueled by industrial effluents and heavy metal exposure too have not been left behind in adding to the despair. Lack of proper management, disposal/reuse/recycle of heavy metals, inorganic and toxic wastes have been on rise in most developing countries including ours. Contamination of water bodies with industrial effluents and toxic elements eventually enter the food chain causing severe damage to human health. Many of these also harbour the property for bioaccumulation bearing the potential to affect generations. The damages caused include organ dysfunctions, inflammation, irritation, damage to the nervous system, congenital malformations to even cancer. Increase in nitrate content through industrial wastes causes its deposition in ground water eventually leading to its entry into the food chain; wherein it can cause fetal complications like methaemoglobinaemia (blue baby syndrome) in infants exposed to the same. Also, a rise in inorganic compounds in ground water can cause eutrophication which becomes breeding grounds for algae and many toxic compound producing cyanobacteria. Such challenges in sanitation have also shown to affect biodiversity leading to its loss.

Proper sanitation - Need of the hour!
Looking at the predicament that arises due to lack of adequate sanitation, it is important for the health communities and welfare institutions to be the first one in taking measures to tackle the menace caused by the same. Considering the ever increasing rate of population, meeting the requirements of proper sanitation becomes imperative. Most of the poor and developing countries which lack to keep stride with the increasing population growth should be the first ones to implement and incorporate strategies in meeting the requirements of proper sanitation.

Rapid and Rampant Urbanization- A Threat to Good Health
We all are aware of this trope, 'a simple farmer pack his bags, takes his mother's blessings and with stars in his eyes, heads toward the big city to fulfill his dreams. Such idealization also translates into reality when, along with modernization and industrial development, urbanization also spreads rapidly. In fact, it is estimated that, by the year 2030, 42% of total Indian population will reside within the cities with inhabitants numbering over 1 million.

This rapid and mostly unplanned growth of cities have, however, made itself a hub of diseases. This is due to a variety of factors. People who live in urban settings fall prey to
The deleterious effects of water, soil, noise and air pollution
Extremely ill-planned waste management
Unhygienic as well as overcrowded living and working environments
Exposure to industrial wastes.

The cramped housing and unhygienic living conditions can increase the risk of all-worne diseases, as well as expedite their cross-transmission between people. Those who live in localities with stagnant water are also more likely to get infected by diseases transmitted through vectors. Some of the diseases which are most common in India are

Malaria Transmitted by the mosquito and caused by the parasite Plasmodium, malaria is responsible for about 1000 deaths annually in India alone. The emergence of resistance to the most commonly used antimalarial drug, Chloroquine has become a cause of concern, with the development of multidrug resistance becoming a more pressing issue.

Tuberculosis As with malaria, the biggest threat with respect to tuberculosis in this country is the development of antibiotic resistance. Further, as this is an air-borne communicable disease, cramped living conditions greatly facilitate its spread. Accounting for 1.7 million deaths in 2016 alone, India bears the greatest burden of this disease. Poor knowledge of both the disease progression as well as diagnostic options are some of the contributing factors for the spread of disease.

Maternal Health Issues
India records one of the highest maternal deaths (approximately 22% per year) throughout the globe. The reasons ranges from poor healthcare accessibility to the remote locations, lack of basic healthcare facilities, quality care and comfort for the mother and her newborn, as well as poor outreach of newborn care programmes. Extremely poor nutrition, below the global average poverty, child marriage and early childbearing, as well as exposure by both mother and child to the harmful substances are other maternal health related issues that need to be immediately addressed.

Most deaths in women during delivery occur due to excessive bleeding and abnormally high blood pressure. Preexisting conditions like maternal anemia are also high risk factors for maternal mortality. The children born under these circumstances are at an increased risk of suffering from many health complications and inborn errors of Metabolic.

Conditions in children
Metabolic disorders like Phenylketonuria and Galactosemia, although are of genetic origin, can be effectively managed with timely and proper guidance so they do not cause any long-term harm to the baby. Certain birth defects may also arise due to nutrient deficiencies or toxins in the mother, and by transmission, to her child.

Malnutrition
As the country is progressing, access to good and nutritious food should become a reality. However, the nutritional status in our country lacks still, not just in terms of deficiencies, but also due to excessive consumption of empty calories.

Nutrient deficiency- In addition to eating less food due to reasons like poverty, the over consumption of junk food while foregoing nutritious homemade food has made many victims of nutrient deficiencies. Vitamin D which can be easily selfsynthesized through exposure to sunlight is still one of the most commonly deficient vitamin.

Heart disease Poor eating habits, especially consumption of excessive carbohydrates are a major risk factor for abnormal levels of fat in the body. These imbalances can lead to accumulation of LDL-bad cholesterol in the bloodstream and can damage blood vessels, resulting to high risk of Cardiac Risk Markers Test. Heart disease is one of the leading causes of morbidity and mortality in our country.

COPD Chronic Obstructive Pulmonary Disease is a lifelong disorder that is characterized by difficulty in breathing due to exposure to some types of irritants, especially those that spreads due to smoking.

Poor Health Awareness
Low educational status translates to poor health awareness, especially for those conditions that can either be completely prevented or managed if detected in time. In this, the difficulty in identifying a symptom as an indication of a much bigger disease and delay in undergoing testing for identifying the disease are common risk factors for transmissible diseases, as is the lack of awareness of proper steps to take to avoid these diseases.

Cancers Cancer

Development of drug resistant TB While TB is a disease that can be cured by antibiotics, the general lack of awareness regarding sticking to the prescribed regimen of antibiotics, among other factors, has resulted in increased number of the antibiotic resistant TB cases. In this condition, the bacteria become immune to some of the commonly used anti-TB drugs, making it difficult to treat

HIV and AIDS When a person is infected by an HIV virus, they are known as HIV positive patients. If this infection is not correctly managed, it can severely compromise our immune system and impair our ability to fight other opportunistic infections. If this deterioration of the immune system continues, then this condition is called AIDS. It is importanti to know that HIV infection is not the end of the line and can be effectively managed if one is aware regarding how to go about it. Risk factors and modes of HIV transmission should be openly discussed to increase general awareness.

As per the Indian HIV Estimation report released in 2015, the prevalence of HIV is at an average of 0.26% among all adults between 15-49 years of age, with the highest prevalence found in the states of Manipur, Mizoram, Nagaland, Andhra Pradesh, Karnataka, Goa and Gujarat.

We see the attempts of our government in improving the health and livelihood of its citizens through the "Swachh Bharat Abhiyan", but what about our own responsibility towards our health and the health of the community as a whole? Ignorance is the first hurdle that has to be surpassed towards achieving a healthy India; after all how can we fight what we do not know.

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