Universal Health Coverage

Universal Health Coverage

                             Universal Health Coverage

On December 12, 2012, a unanimously passed United Nations resolution marked the day for Universal Health Coverage. It has now been two years since the endorsement for universal health coverage, that has since become the pillar for sustainable development and global security. The goal of Universal Health Coverage is to ensure that all people obtain health services they need without financial hardship.This requires a strong, efficient and well-run health system.

Such a system of financing health services includes access to essential medicines, technologies, along with a cadre of well-trained and motivated health workers. India’s efforts in these directions had already begun since 2005 with the advent of the National Rural Health Mission, launched to offer accessible, affordable and quality health care to rural populations. The intent was to cater to the most vulnerable sections. The focus of the Mission is to reduce Maternal Mortality Ratio, Infant Mortality Ratio and Total Fertility Rate.

The United Nations in India supports the Government of India to move forward towards Universal Health Coverage. For this purpose it provides evidence, technical and policy advice on effective interventions as well as mechanisms to monitor all progress. The WHO Country Office in India works in conjunction with ten leading world organizations for the purpose. These are Department for International Development (DFID), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), International Labour Organization (ILO), UNAIDS, United Nations Development Programme (UNDP), United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF), United States Aid for International Development (USAID), and the World Bank.

All these organizations work together to promote better support and commitment to Universal Health Coverage in India. Both the NRHM and the recently launched National Urban Health Mission (NUHM) are now included under the National Health Mission (NHM). Although some progress is made in bits and spurts, especially after formation of NHM there remain widespread challenges that need to be tackled. Some home truths emerge, that need to be taken cognizance of:

  • Inadequacy of availability of health care services (both public and private sectors).
  • Questionable quality of healthcare services (both in public and private sector).
  • Regulatory standards for public /private hospitals are inadequately defined and remain ineffectively enforced.
  • Affordability of health care remains a serious handicap, more so for majority of impoverished populations.
  • Most people incur heavy expenses for medical services purchased from the private sector.
  • The total expenditure on health care (both public and private together) is 3.7 per cent of the GDP.

The first-ever Universal Health Coverage Day was observed in New Delhi to mark the two-year anniversary. The high-level event convened by the Public Health Foundation of India and World Health Organization, was supported by Rockefeller Foundation and Oxfam India as part of a coalition having over 500 health and development organizations. They are all attempting to accelerate reforms that ensure health services be provided to all citizens. The quality of health services, medicines and diagnostics will hopefully be improved, thereby facilitating efficacy of National Health Assurance Mission. For doing this successfully the entire medical fraternity at all levels needs to pitch in to make a go with combined efforts.

Health For All

                                       Health For All

Safety First for Our Women and Girls

Safety First

Safety First

While the state owes responsibility for safety and security of its citizens, looking into the current scenario of crimes against women it now appears we need to instill self protective measures to keep women prepared from nefarious eventualities. The political will to tackle this menace defies explanation. It is beyond comprehension what the government has in mind when it comes to addressing critical safety issues. Stringent capital punishment is the only way to contain this crime. It is mind boggling that the utilization of Rs. 1,000 crore under the Nirbhaya Fund remains untouched! What are we waiting for when every day we witness occurrence of assault and fatalities among women of all ages.

The latest incident involving the rape and victimization of a woman financial analyst by a taxi driver in Delhi brings all the angst and worry back again. Plans to make the One Stop Crisis Centers for women operational have not found their mark. Perhaps the files have not moved. We read reports stating “the various schemes were yet to be finalized”. Does the government still think this is non-serious business and hopes to dust it under the carpet? Or bicker over it during zero-hour? It is time now that women followed some safety precautions to avert and allay these kinds of sinister events.

A planned personal-safety approach would be good for women who have to go outdoors on their own. Women are of course constantly targeted the moment they step out of homes. Be it the domestic help, college student, office worker or tourists – they become the cynosure of molesters and rapists. The incidents of harassment and aggression happen right there on roads, buses, metro trains – in fact everywhere. Precautions may be taken to outwit offenders and to ward off unwanted advances. Safety training should be routinely drummed into minds of young girls.

Women should follow a set of common-sensical tips to train their minds to circumvent such incidents. They should keep family members aware of their activities who should check on them constantly. Next, your demeanor should appear to discourage advances. Always walk with confidence since predators seek out timid and vulnerable looking victims. At all times be aware of immediate surroundings and listen to your gut feeling. Do not draw unnecessary attention to yourself so as to unwittingly attract a predator’s interest. If confronted by a person look him straight in the eye and question his behavior loudly. Most predators avoid public attention. Avoid being alone after dark and stay away from isolated areas. It is a good idea to enroll for personal defense classes to learn basics of hand combat for women. Find out where you can buy personal alarms, protection devices like pepper sprays and mobile phones with emergency apps.

Cell phones today can be used most effectively in case of emergencies. They are helpful for women who have to travel a lot. Safety apps for women reduce the risk of travelling through unfamiliar territories. These applications can be found on smart phone systems. The most common of such apps allows you to alert your family when you are in danger. Just two taps send predetermined messages to six close friends or relatives. They will also convey your exact location and address. Another app allows you to capture a picture of the attacker to a harassment prevention internet site where he is identified. Another smart phone app sends alarms to multiple guardians simultaneously. While one of them would be receiving a phone call, others would be receiving messages.

As they say self help is the best help. So by the time we wait for state systems to become effective let us teach our women and girls to be mindful of their lives.  A well defined safety plan is the best bet. One does have to go out – study, work and earn livings. And so they best know how to take care. Women today must have the strength and determination to fight back violence without fear, embarrassment or guilt.  Be aware, be prepared and be on guard. Finally check out this wonderful American website http://www.justyellfire.com/. Watch especially the 20 minute video that teaches girls how to fight back against sexual assault and abduction. Since 2006 this website has empowered 1 million girls in 44 countries with getaway skills and the right to live without fear of being a victim of sexual assault.

Be Your Own Vigilante

Be Your Own Vigilante

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!

Fate of HIV and AIDS (Prevention and Control) Bill 2014 Still Hangs

December 1 observed as World AIDS Day

December 1 Observed as World AIDS Day

The AIDS epidemic in India is not hidden anymore. We know for a fact that now our villages too are affected by the scourge. As per the U.N. AIDS Programme India, at the end of 2013 had the third-largest number of people living with HIV in the world. This accounts for over half of the AIDS-related deaths in the Asia-Pacific region. It is time we sat up to take stock of the situation.

Today December 1, is observed as World AIDS Day. We in India, have managed to create awareness and made strident efforts towards combating the dreaded disease. We have involved local governments, NGOs, educational institutions, schools and the civil society to get support for the cause. And it has been with all such support that we have been able to reach out to the people.

Nearly 9 lakh Indians are dependent on ART drugs to lead relatively healthy lives. Affected people start therapy with required medicines that are needed to be taken daily as per proper adherence. Failing this the drugs rapidly become ineffective. Once this happens they then have to switch to a second line of treatment which is five-times more expensive than first-line drugs.

Even for the first line medication urgent intervention are needed to ensure that people living with HIV and AIDS get these life-saving anti retroviral Therapy drugs. While being able to get the drugs remains a major area of concern, it is the long-pending HIV Bill that’s needs to be passed by the Indian Parliament is also a grave area of concern. The Bill drafted in 2006 aims to protect the rights of people infected and affected by HIV. It would hopefully provide protection of HIV-positive people and their family members from stigma and discrimination.

It is therefore very imperative that the decision makers agree to pass the HIV and AIDS (Prevention and Control) Bill 2014. All along stakeholders have been focusing on spreading awareness about access to drugs as well as diagnostics for People Living with HIV. Positive public support has also been acquired for resolving this issue. HIV is now long past been a medical problem. It now cuts across social, economic, psychological, medical parameters to move into the domain of human rights.

The HIV bill provides protection against human rights violations and since having been tabled in the Rajya Sabha (Upper House) of Parliament, has now to be passed as law. Experts urge that the government should urgently pass the HIV and AIDS Prevention and Control Bill 2014 as soon as possible to provide drugs and diagnostic services for free to those who are affected. According to the United Nation’s, India has around 2.2 million people being affected by HIV AIDS.

Life-Saving Anti Retroviral Therapy Drugs

And The Band Played On

And_the_band_played_on_Varese_VSD_5449

Produced in 1993 “And the Band Played On” is an American documentary based on the best-selling 1987 book entitled “And the Band Played On: Politics, People, and the AIDS Epidemic” by Randy Shilts. The film is directed by Roger Spottiswoode and written by Arnold Schulman and has a cast of well known actors. The docudrama weaves around the discovery of the AIDS epidemic and the political infighting of the scientific community obstructing the early fight with it.

The film takes you back to the days when the undetected disease was considered a mysterious threat but one that no one dared face up to. The fight for the affected many was being fought by but a few. No one wanted to even speak of it. Many still feel the same way about AIDS even today. However, recent years have lent due attention to the malady by donor agencies and philanthropists who have kept the fight up for affected people and to combat its spread.

It is with a sense of gratefulness that one watches the film that had first premiered on September 11, 1993. The prologue of the film takes you back to 1976 when American epidemiologist, Don Francis arrives in a village on the banks of the now famous Ebola River in Zaire, where he discovers several residents and doctors working with them to have died from a mysterious illness later identified as Ebola hemorrhagic fever. This initial exposure to an epidemic becomes a haunting leitmotif when he subsequently becomes involved with HIV and AIDS research at Centers for Disease Control and Prevention.

It is only in 1981 that Francis becomes aware of a growing number of deaths from unexplained sources among gay men in Los Angeles, New York City and San Francisco that prompts him to begin an in-depth investigation of the possible causes. Working with no money, limited space, and outdated equipment, he interacts with politicians, the medical community and gay activists. But many people resent his involvement because of their personal agendas.

Bill Kraus a gay activist supports him but several others dislike unwanted interference in their lifestyles. However Don Francis pursues his theory that AIDS is caused by a sexually transmitted virus on the model of feline leukemia. His efforts are stonewalled by CDC itself that is not keen on proving the disease to be transmitted through blood as blood banks would become suspect, as eventually they were. Albeit later CDC itself came to compete with French and American scientists squabbling over credits for discovering the virus!

Meanwhile death toll from the virus keeps climbing rapidly. The film closes with footage of a candlelight vigil march in San Francisco, followed by a series of images of persons dead and affected with HIV and those who have since then been involved with HIV education and research. The film takes you back in time to bring out the facts and figures of the history of AIDS. It is inspirational in a sense how few committed souls played a role in understanding and combating AIDS infection.

HIV-treatment

HERD Foundation Medical Clinic in Pauni – The Outbacks

Pauni Clinic

                                  HERD Foundation & Lata Mangeshkar Hospital Out-Patient Clinic Inauguration at Pauni

HERD Foundation and Lata Mangeshkar Hospital established a new medical clinic in Pauni, Ramtek District that primarily serves low-income tribals and villages settled around here. Word of mouth publicity steadily draws patients in large numbers to the clinic that sits by the highway road in the main bazaar of Pauni. Initially being run three days a week – Mondays, Wednesdays and Fridays, patients line up well in advance at the open space in front of commercial building standing just off the road.

An opening ceremony took place on September 9, 2014 for this new Out-Patient Department Clinic located on the Highway No. 7 at the Main Bazar of Village Pauni, 75 kms from Nagpur. The clinic inaugurated by Smt Roopatai Deshmukh and Vice-Dean Dr H. Kanade, NKPSIMS had local panchayat members, HERD Foundation staff and local people present for the inaugural function. Villagers looked happy that they were to get access to medical services in their village.

HERD Foundation is locally well-known because of the series of medical camps that were undertaken in the region. Looking at the dearth of medical services and on insistence of local people the decision was taken to open a local clinical center offering check-ups, diagnosis and treatment options through services of in-house doctors. The clinic hours are 10:00 to 02:30 in the afternoon. But in reality we get such a flow of patents that doctors are busy till five in the evening.

The team of doctors is experienced, compassionate and well versed in public health services who are working hard to get the patients on the road to recovery. Serious patients are assisted in getting immediate medical attention at Lata Mangeshkar Hospital at their varied departments as the case maybe – Medicine, Obstetrics & Gynecology, Pediatrics, Orthopedics, Ophthalmology, Surgery, Dental and ENT Departments. For the nearly 400 patients checked on six days in the clinic that opened just two weeks back, there’s been much relief.

The clinic is proving to be useful in this remote region for the largely tribal population availing of medical services. The clinic aims at providing primary care to tribal belt of patients whose numbers keep surging. The larger-than-expected numbers proves the need for such assistance in an area where there is severe shortage of doctors, nurses and primary care health providers. They get ready access to specialist doctors, to even receive emergency care in needed cases.

The Pauni Clinic is a community health center operated by HERD Foundation that’s been set up after a bit of redesigning to make healthcare more accessible to patients living in remote forested areas. Our goal is to extend medical services for these neglected people in a region where primary health care is nearly non-existent. Right now it’s looking to be a great venture and we feel sure that it will be a success. Its working great and we know for sure that in the times to come, we would have done a remarkable service.

Access to Medical Services

                                                           Patients Surging With Each Passing Day

OUR ROLE IN PUBLIC SAFETY AGAINST GAS PIPELINE HAZARDS

Image

Gas pipelines are part of rural spaces in our country and are essential to the nation’s industries. They are considered the safest most reliable and efficient manner of transporting natural gas or other petroleum products. The companies running these pipelines must work hard to maintain a safe and reliable system to avoid the occasional leak or damage that may occur. In case a natural gas pipeline gets damaged it will result in severe injury or death through ignition, explosion or asphyxiation. 

It therefore becomes very important to take active steps to ensure that the health, safety and security of the communities and the environment along these pipelines are well maintained. The companies involved should conduct routine monitoring and patrolling of the pipelines to ensure safety of the people around them.  Likewise communities settled alongside must report emergencies like gas odor or anything suspicious.  

In case you detect gaseous smells there are certain precautions to be taken immediately.

  • Leave the surrounding site immediately and warn others.
  • Don’t turn on or off any electrical appliances – not even battery switches or cell phones so as to avoid creating a spark.
  • Call emergency services immediately from another location.

There are several signs that can indicate a leak is present. If you see any of these signs, please notify immediately to get going with investigation of the situation.

  • Hissing sound or odor of gas near a pipeline.
  • Ice formation on the ground above a pipeline.
  • Distressed or dead vegetation above a pipeline.

Gas pipes have a job of their own to do and shouldn’t be used for anything else – certainly not clothes-lines, free-form closets or grounds for electrical appliances. Avoid damp corrosive environments around gas pipes and take corrective action if you see a badly corroded pipe. Call and report this condition of a badly corroded pipe immediately.