Mother and Child Mortality

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Our country has fallen short of the under-five child mortality rate target of 42 per 1,000 live births by 2015. The Lancet medical journal informs that India fell short, but what appears worse is that India does not figure in the list of 62 countries (Bangladesh and Nepal are there) to have achieved the desired Millennium Development Goal!

However the Union Health and Family Welfare Ministry is yet hopeful that we can achieve targets! Offering reasons for gaps it concurrently stepped up interventions in identified 184 high-risk districts. The fact of the matter is more than half of child deaths occur in the first month of life! Also clinical causes create complications of premature delivery. Infectious diseases are also responsible for deaths right from first month of life up till five years.

These are frightening aspects in this day and age! India has the highest number of child deaths in the world! Nearly 1.2 million deaths in 2015! That is 20% of 5.9 million global deaths. Countries topping this macabre list include Nigeria, Pakistan, Democratic Republic of Congo and Ethiopia. Add to this the fact 44,000 women in India still die every year during pregnancy and childbirth. Half the women who die in India are under the age of 21!

It is for this reason that public health experts and NGOs advocate the creation of special cadre of nurse-midwives, especially for rural India. Such midwives need critical training with adequate payment for their services later to make a go at things. A cadre of trained nurse-midwives will decidedly contain maternal and infant mortality rates. Doctors are not always available everywhere and this critical niche cadre can help control pregnancy related deaths of mother and child.

It is said that only 10-15 percent of high-risk women need referrals by midwives for emergency care and specialist interventions that can be interlinked with nearest hospitals. As of now there are few specialty courses available for midwives/dais to be trained accordingly. Some innovative programmes developed by medical institutions along with healthcare NGOs are experimenting on and off. This is an area that needs to be explored seriously to get dais, ANMs, ASHA workers, health-workers and the like to be effectively trained in midwifery.

With specialized skill sets they can actually be readily recognized as health providers to play a crucial role in needed areas. Given proper training they can perform a far important and useful role in containing mother and child mortality rates. This will be especially critical at the grassroots level. A separate cadre of midwives will not only ably assist birthing but by upgrading their financial status, providing clarity to their role it can open up career opportunities. While at the same time they will help in addressing health needs of under-served rural areas.

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Human Body Donation

Body Donation

Body Donation

For some of us making an offering of our own dead body for the good of society is an opportune way to give back to humanity. Nowadays many more people are choosing to donate their bodies to medical study and research. This is usually because donors or their family members have had the benefits of life saving medical technology or procedures through organ transplantation. However this may not be the only reason as many others simply opt for altruistic reasons for donating bodies.

Body donation has the person giving away the entire body after natural death for purposes of medical research and education. It is true the need for bodies for medical study is always there and research on them can continue to save lives. Body donation is a choice one exercises while alive, and one may or may not discuss even within the family. All you need do is contact concerned authorities and fill out the necessary paperwork to give your body to medical institutes.

It is usually medical colleges that accept dead human bodies for donation that are required for teaching students. It is a useful gesture that helps students understand human bodies and is also essential for reasons of advancing knowledge of medical sciences. Medical colleges make use of bodies to teach anatomy to medical students. They may cover the cost of cremation or burial once the cadaver serves its medical purpose or they may return the body back to the family for ritualistic interment.

Any person who wishes to donate a body has to make certain prior arrangements with local medical colleges and complete formalities before death. This usually involves filling out consent forms and completing requisite information therein. It is at this time that the person is also provided with the relevant details of processes and procedures that will take place after expiry.

Every country has its own rules and regulations with regard to accepting body donations. In United Kingdom body donation is governed under the Human Tissue Authority Act, 2004 that gives licenses for the purpose and inspects medical establishments accepting bodies. In the United States body donation is not regulated through licensure and inspection by the federal government. But the American States are subject to their own legislation of tissue donation under the donor’s legal right to choose body donation under the Uniform Anatomical Gift Act. In India after various amendments to Odisha Anatomy Act, some states have legalized voluntary body donation. People in India can donate their body after death by signing a pledge form along with two accompanying witness signatures.

Decisions regarding body donations are influenced by your sense of social awareness, cultural attitudes and your thinking about body donation. A number of donors are influenced by a sense of altruism and by their wish to assist in the advancement of medical knowledge as also to be useful after death. Also one may be driven by need to help future generations, be useful for medical field or simply to avoid funeral ceremonies.

Steps for Body Donation after death:

  • Contact medical facilities that accept whole body donation.
  • Fill out registration and consent forms to donate your body.
  • Keep a wallet card that notifies people of the intention to donate the body.
  • Complete transport arrangements with the facility of your choice.
  • Inform your doctor and immediate family members about the intention.
  • You may determine what you want for your body after it has been studied.
  • Make alternative arrangements. Some bodies not suitable for medical study in case of major operation done to them are returned to families.
  • Think about what you want done if your body is unable to donate itself to science.
  • You can cancel your decision any time by notifying the medical college in writing.
"Even in death do we serve life":

“Even in death do we serve life”:

International Thank-You Day – January 11

International Thank You Day

International Thank You Day

HERD Foundation takes the opportunity to thank everyone on the occasion of International Thank-You Day celebrated on January 11. Belated as it may be, this singular day is marked out to thank someone for something special. And so we take this moment to thank all people, supporters and volunteers who helped us on in this great journey. We share our deepest thanks with each one of us who really deserve to be acknowledged for hand-holding and cheering us on in the fulfillment of our dreams.

This special day matters to us, as often enough in our busy routine and rigors of daily living we may forget the niceties of life. Sometimes we do not really even have the time to say these two beautiful short words “Thank You”. May be this is why the day was assigned and set aside so that we appreciate the parts played by everyone around us and who is important to us in the fulfillment of our endeavors.

The International Thank You day is a great opportunity to start of the New Year on a new note by thanking everyone. Just as the holiday season is getting over and once again we delve back into work and business, along comes this day reminding us all that something essential needs to be done. January 11 as International Thank You Day starts us on by showing appreciation to people who make our lives better.

We do believe that all of us have plentiful people to thank something for.  Perhaps it is a day that helps each one of us cultivate goodwill by expressing our gratitude. This special day may add just that much more meaning and fun by conveying and celebrating the quintessential importance of  International Thank You Day! So go ahead and say your own thank-you messages. We usually miss the opportunity to express our gratitude to friends and colleagues – let us thank each other for our countless blessings. Let us all ingrain gratitude.

THANK YOU

THANK YOU

Nosebleeds in Elderly are Serious

Nosebleeds are Serious

Nosebleeds are Serious

Nasal hemorrhage or nosebleeds are called epistaxis in medical terms. Positioned in the middle of the face a nose is full of blood vessels making people susceptible to nosebleeds. Although nosebleed may not be a cause for alarm in youngsters, but nosebleeds in the elderly can be life threatening. Ruptured blood vessels can cause the nose to bleed profusely.

Nosebleeds occur in old people taking anti-coagulants or blood-thinning medications like aspirin. If a patient is taking anti-coagulants, has high blood pressure or blood-clotting disorder then the bleeding will be harder to stop and may last up to twenty minutes. There are two types of nosebleeds – Anterior and Posterior.

Anterior nosebleeds originate from the lower nasal septum and occur mostly in children. The wall between the nostrils contain delicate blood vessels that receive blood from the carotid arteries, two principal arteries in the front of the neck that supply blood to the head and neck. A slight knock or bump causes these vessels to bleed that may be treated at home.

Posterior nosebleeds originate further back and higher up the nose where artery branches supply blood to the nose, which is why it is heavier. Posterior nosebleeds are very serious and require immediate medical attention. They are more common in the elderly. Causes of posterior nosebleeds are high blood pressure, calcium deficiency, cold dry climate, atherosclerosis or daily aspirin use. Such nosebleeds can be dangerous and the older the patient, the more serious is the nosebleed.

One has to be given immediate medical attention. A nosebleed can be really frightening both to the onlooker and to the one it occurs to. Most nosebleeds look much worse than they really are. Help the patient to sit down and lean slightly forward. Keeping the head above the heart slows the bleeding. Leaning forward stops the blood from going down the throat into the stomach.

The usual remedy in a hospital is to either pack the nose or cauterize the bleeding vessel. Cauterization uses a special solution or an electrical or heating device to burn the vessel to stop bleeding. The doctor numbs the nose before the procedure. Packing the nose with special gauze or inflatable latex balloon makes sure enough pressure is placed on the vessel to make it stop bleeding.

After-care is essential and the patient must avoid blowing nose after a nosebleed. Use a humidifier in cold dry climates. If one is prescribed anticoagulants (blood-thinning medications) discuss concerns with physician. To prevent recurring nosebleeds avoid exerting or straining and avoid causes of occurrence.

Consult an Expert

Consult an Expert

For a Better World – Millennium Development Goals

Millennium Development Goals

Millennium Development Goals

Millennium Development Goals or MDGs are time-bound, quantified targets the world had set for itself. The goals addressed extreme poverty, hunger, disease, lack of shelter and to promote gender equality, education and environmental sustainability. It was in 2000 that 189 nations pledged to free the world from such debilitating deprivations. The pledge was converted into 8 MDGs that were to be achieved by 2015.

In September 2010 the world connected again to recommit itself to accelerate these goals. Presently the UN agenda too rests on these MDGs and the target is to reduce by half the proportion of people without access to basic sanitation by 2015. The UN Millennium Campaign since 2002 supported and inspired people from around the world to take action for the MDGs.

While some countries made remarkable efforts in achieving health-related targets others have lagged behind. The countries making the least progress were actually affected by economic hardship or conflict. However targets are yet being adhered to and the 8 MDGs ranging from cutting extreme poverty by half, restricting HIV/AIDS and providing primary education are all target bound until 2015.

The blueprint for action agreeable to all countries received support from leading development institutions. These agencies spurred the process with their exceptional assistance so that targets could be achieved. The UN itself works with governments and allied partners to keep up the momentum. In fact health related targets were hand-held by World Health Organization to support efforts for achieving targets. WHO helped in developing health policies for governments to align priorities and track progress as also to disseminate data to plan spending patterns.

The Indian government too chalked out its 12th Five-Year Plan in conjunction with MDG targets to achieve faster and sustainable results. It brought about inclusive growth by incorporating the MDG working frame. This further ratified the potential for prioritized action on the MDG agenda. The ‘Millennium Development Goals (MDG) India Country Report-2014′ captures India’s progress that will be achieved by 2015. 2014, being the penultimate year for the efforts proved significant in realistically assessing progress.

All progress towards reaching these goals have seen mixed results. Despite unforeseen setbacks the reduction in poverty and increased access to health, education, technology and other essential services in many countries’ have been made into a reality. Of particular note is the work undertaken on AIDS that saw dramatic leveling off and decline. The world now looks ahead to the new set of goals established for 2016-2030.

End Poverty & Deprivation

End Poverty & Deprivation

Status of Eyecare Health in India

Stand Alone Eye Clinics - Need of the Hour

Stand Alone Eye Clinics – Need of the Hour

Our country is the second most populous in the world, having 23.5% of the world’s blind population. The prevalence of blindness and visual impairment remains a major problem. Cataract, corneal opacities, glaucoma and posterior segment conditions are key reasons for blindness. These conditions can be treated only by skilled eye doctors in a hospital setting. We need to establish evidence for occurrence of eye problems by conducting baseline surveys to understand precise prevalence of specific conditions.

A national program for control of blindness was started in 1976 in India. Unfortunately it has not been possible to generate enough information for all of the country. However detailed information has been gathered in certain areas through research studies by concerned eyecare agencies. All such studies have shown that prevalence of cataract as the most common cause of blindness. Up until quite recently prevention of blindness was therefore largely cataract-focused.

Of late now ophthalmologists are being trained to increase emphasis on focusing on other critical causes of blindness like refractive errors, childhood blindness, corneal blindness and glaucoma. An ophthalmic workforce and infrastructure survey was undertaken to provide a valid evidence base for human resource and infrastructure requirements for elimination of avoidable blindness. This was the first time that such an extensive survey has been undertaken.

The study was conducted by Ophthalmology Cell, Ministry of Health and Family Welfare, Government of India from April 2002 to March 2003. Pre-tested questionnaires were administered to all district-level blindness officials and ophthalmology training institutions and supplementary data sources were used too. Data analysis and projections of existing ophthalmologists and dedicated eye beds were made for the entire country using the mean, median and range for each individual state.

The study ascertained that more than half the eye care facilities were located in the private sector. Sixty-nine per cent of the ophthalmologists were employed in the private and non-governmental sectors. 71.5% of all dedicated eye beds were managed by these two sectors. Five states -Maharashtra, Uttar Pradesh, Karnataka, Andhra Pradesh and Tamil Nadu had half the practicing ophthalmologists in India. There was a wide disparity in access to ophthalmologists and dedicated eye beds across the country.

In order to meet these requirements India will have to work hard to achieve the goals of Vision 2020. Some states and certain regions will be needing special attention. Instead of an across-the-board increase in ophthalmologists and eye beds, regions which are deficient will need to be prioritized and concerted action initiated to achieve an equitable distribution of available resources.

Shockingly, as per this study an estimated 9031 ophthalmologists worked in eye care facilities in our country. Of these 69% (6235) worked in the private sector and 31% (2796) worked in government sector. This clearly shows the disparity in availability of ophthalmologists. We need to increase the efficiency of eye care system in India by increasing the availability of ophthalmologists. Also we need to generate more eye doctors and eye specialists. It is only appropriately skilled ophthalmologists and trained technical staff that can respond to eyecare health in India.

Preventable Child Blindess

Preventable Child Blindness

Sushruta – Medical Pioneer of Ancient India

Sushruta – Medical Pioneer of Ancient India

Sushruta – Medical Pioneer of Ancient India

Sushruta is considered one of the earliest surgeons in recorded history and has been the first individual to describe plastic surgery in his famous ancient treatise ‘Sushruta Samhita’. He is said to have lived nearly 150 years before Hippocrates, and his renowned compendium written in 600 B.C. spells out surgical procedures in minutest detail. He is also credited to be the first surgeon to perform plastic surgery!

Many believe plastic surgery to be a new specialty. However its origins are ascertained to have existed over 4000 years back in India. The Vedas compiled in Sanskrit language between 3000 and 1000 B.C. comprise of the oldest sacred books of the Hindu religion. Of the four Vedas – ‘Sushruta Samhita’ is a part of Atharvaveda. The treatise describes ancient Indian tradition of surgery and remains a most brilliant compilation in Indian medical literature.

The treatise contains detailed descriptions of teachings and practice elucidated by this great ancient surgeon said to have been practicing in Varanasi. It also provides surgical knowledge that is of relevance to this day. As a pioneer in the field of surgery, Sushruta expounds prolifically on the healing arts that were grounded on physiology and medicine. He studied human anatomy with the help of dead bodies! Much as in medical colleges today.

The Samhita specifically describes methods for selecting and preserving dead bodies to be studied. Cadavers of elderly or severely diseased were not taken up for purposes of study. Bodies needed to be perfectly clean and were preserved with barks. They were placed in cages, hidden carefully in the river for currents to soften them. After seven days they were retrieved, cleaned with brushes for inner and outer body parts to be seen clearly.

Over 1100 diseases are mentioned in this ancient tome including 26 types of fevers, 8 kinds of jaundice and 20 different urinary disorders. There are 760 plants inclusive of roots, bark, juice, resin, flowers etc. that are described in detail for treatments. These also include common household remedies like cinnamon, sesame, peppers, cardamom, ginger and more. Additionally the treatise offers descriptions of 101 instruments used in surgery.

Sushruta’s greatest contributions were in the fields of plastic surgery and removal of cataracts. In a time when cutting of nose or ears was a common punishment, restoration of these parts and even limbs lost in wars was a common medical practice. There are detailed and accurate step-by-step descriptions of such operations. Strikingly these are the very steps followed by modern surgeons doing plastic surgery even today.

Serious procedures were undertaken like drawing fetuses out of wombs, repairing damaged rectums and removing stones from bladders. Surgical techniques included incisions, probing, extraction of foreign bodies, cauterization, tooth extraction, excisions, draining abscess, draining hydrocele, removal of prostate gland, urethral stricture dilatation, hernia surgery, management of haemorrhoids, fistulae, intestinal obstruction, perforated intestines, and accidental perforation of abdomen. Students were given knowledge of relevant branches of medicine to attain proficiency in allied subjects.

Sushruta Samhita remains an important text on medicine that is also a foundational text for Ayurveda. This seminal text was translated to Arabic as Kitab-i-Susrud in the 8th century. The Arabic translation was received in Europe by the end of the medieval period when Renaissance Italy became familiar with the techniques of Sushruta Samhita. Among other translations since then, more recently in 1999, P. V. Sharma undertook an English translation of this ancient Indian medical treatise.

First Surgeon Performing Plastic Surgery!

First Surgeon Performing Plastic Surgery!