Public health challenges in India

Public health challenges in India:
Are a billion people too much to handle? Pessimistics will view the picture as crumbling infrastructure coupled with an ailing , albeit non existential primary health care sector. Optimists see it as a manpower driven nation on the revolution bandwagon. I see it as a nation that needs nurturing of appalling public health awareness levels. People endowed with knowledge can care for themselves. They do not need the powers that be to tell them what is good or bad for them. The critical public health issue with our nation is that clear cut guidelines are seldom implemented. Policy and advocacy matters are so clearly flouted that it is no wonder to see apathy of the common public to matters of grave public health importance. It is indeed sad to note that only panic mobilizes our populace. It is this callous image that we have of public health that needs a change for the better.
The biggest challenge is the twin epidemics of chronic diseases and infectious diseases that are steadily making inroads even into the bucolic communities. Sanitation and hygiene have improved considerably since the past 30 years only to be replaced by scarce facilities/resources for the burgeoning population. An ever growing middle class with burgeoning consumerism attracts it’s own pitfalls. Statistics are pointing to a trend of increasing lifestyle disorders, but that is just the tip of the iceberg. Primary prevention with adequate focus on public education will go a long way in reducing the increasing burden of cardiovascular and Lifestyle related diseases
Imparting education to grass root level health care workers makes an enormous difference. Oral rehydration therapy is a case in point. The scourge of infant related diarrheal diseases came down on account of widespread education of simple sugar and salt therapy imparted by Angan wadi workers. My initiation into public health started with this simple concept of imparting knowledge to the entire field staff involved in my rural communities. Medical knowledge needs to be simplified and demystified for the public to appreciate the fact that simple preventive measures can make a big difference in their quality of life care and medical costs.
It needs a good ear and a clear sight to look into the future and most importantly to share a common vision that has inputs from all those involved in the health care sector. For a country steeped in ignorance and economic impoverishment, education on public health issues is far paramount than allocating budgets. A case in example is the AIDS pandemic and MDRTB. A majority of CSW’s know about condoms, but they don’t bat an eyelid if a client pays them extra money for unprotected sex. Similar is the case with TB. RNTCP is making rapid strides in converting sputum positive rates thanks to the educative initiates taken by the local health workers. Educating that sputum conversion is important than X ray diagnosis to basic health workers has made such a difference.
Hence, I wish to write, communicate, pursue research and educate the common public and empower them. To achieve that, the lack of public attention to health, the persistence of the notion that health is a personal responsibility (and ill health a personal or cultural failure) needs to be changed.