There is no denying that remarkable progress has been achieved in the realms of science and technology, particularly medicine, inforamation technology, communications, infrastructure development, food production, speciality hospitals in the cities, etc. Yet medicare for the millions of poor and the lower middle class familes still remian a luxury. Millions of people are still trapped in the vicious circles of poverty, malnutriton and disease. Lakhs of people still suffer from tuberculosis and many succumbing to it. The incidence of infant mortality and maternal mortality still remains high. Where illiteracy and poverty reign supreme, people pay little heed to hygiene, personal cleanliness and environmental santitation, leading to problems of health. There are hundreds of human habitations in India which have no basic medical facilities; if there are health centres, there are no doctors. If there are doctors, there are no medicines. And those who need special care, they don’t have enough money to buy the mediciens and pay the doctors’ bills. For the bulk of the poor, health and survival still remain a luxury. So health for all is a distant dream.
The greatest truths are the simplest. We can hardly overlook the role environment plays in our health. Water, food, housing, sanitation and education are all important pre-requisites for health. If they are neglected curative repair is only partly successful and may even be impossible.
No doubt, we have achieved a lot on the helath front, but we cannot afford to remain complacent if we want to attain the levels of health reached by people in the developed countries.
There are National Health Programmes for malaria, TB, leprosy, blindness, AIDS, cancer, etc. The National Anti-malaria Programme is the world’s biggest health programme against a single communicable disease.
India accounts for nearly one third of the global cases of tuberculosis. Year after year around 20 lakh people fall victim to TB and out of this huge number, eight lakh become highly infectious smear-positive patients. And about five lakh die of TB every year.
A Revised National TB Control Programme (RNTCP) was launched in 1997 with a view of curing 85 per cent of the new smear-positive cases and to detect at least 70 per cent of such cases. RNTCP is based on the WHO recommended DOTS (Directly Observed Treatment Shortcourse) strategy and is being implemented with the assistance of international agencies like DANIDA and World Bank. The present coverage under the programme is more than 400 million of the population and it is proposed to cover 500 million population this year.
Some of the main components of our National AIDS programme are priority-targeted interventions for groups at high risk, preventive interventions for the general community, promotion of voluntary counselling and testing facilities, blood safety and prevention of occupational exposure and low cost AIDS care to people living with HIV/AIDS. The estimated number of HIV infections were 3.86 million in 2000.
In all, there are 20 to 25 lakh cases of cancer in the country and about seven lakh new cases emerge every year. As cancer has a high rate of mortality, unless detected and treated early, the emphasis is on prevention, early detection of cases and augmentation of treatment facilities in the country.
The state of health today is far better that what it was in 1947. But the overall situation is far from satisfactory. Just building a few five star hospitals or speciality hospitals will only serve the minority of the rich. The basic objective should be that medical care should be within the reach of every needy person in the country. For this, the government agencies, NGOs providing medical care, specialists, doctors, paramedicals, pharmacists and others concerned, should work as a team. Medical service should not be just reduced to the pure business of making fast bucks. Doctors still refuse to serve in the villages. That was the position decades ago and the situation has not changed at all.
The government must realise at the same time the need for preventive medicine. Though India boasts of world’s No. 1 milk producer yet have we ever cared to think over its large-scale adulteration with synthesised milk, causing deadly diseases like cancer. Even fake mediclnes are being sold under the labels of standard companies with impurity. The cost of medicines is going up day by day. The docotors and the para medical staff are hands in glove to pilfer away costly medicines from hospitals and dispensaires, the latter don’t have even bandages or cotton for dressing. Where all these supplies go? Visit any dispensary in rural or semi-urban areas, there is hardly any medicines except the common paracetamol for fever or avil for allergy.
Prevention is better than cure. Health is not just hospitals, doctors and durgs. It is the duty of the government and the society to create the ideal conditions for basic health. These ideal conditions include steps to reduce poverty, safe drinking water and basic sanitation inputs, inculcate habits of hygiene and personal cleanlines and educate the masses on fundamental of health through inter-personal contacts, group discusions, traditional media like pupperty, folk drama and modern media like radio, newspapers and TV. On the curative side, it should be possible for every citizen to receive the treatment and care the needs.
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