I got new medical knowledge watching ads in American TV the other day.
Being a practicing medical doctor specialised in Internal Medicine, who tries to keep his awareness of medical advancement in his field up to date, this was a surprise for me. The ad I am referring to was about a monthly injection to prevent migraine headache approved last year by US FDA.
Three news stories coming out from India this week highlight how unequal the country is in regard to scientific temper and use of science and technology.
First the good news.
India’s space agency debuted a massive rocket on Monday, launching it from the southeastern barrier island of Sriharikota. The Geosynchronous Satellite Launch Vehicle (GSLV Mk III) will function mainly as a delivery system for heavier satellites, but the Indian Space Research Organization hopes that it can one day carry a manned mission — the country’s first — beyond Earth’s atmosphere.
Image courtesy PTI
Does the gender of your physician play any role in the outcome of your illness ?
I know many patients who are not so confident in getting treated by a female physician. They feel women are not up to the mark in solving complex issues in medicine though they are very comfortable to be under the care of a female nurse. Such misconceptions based on gender is prevalent widely and is probably one of the reason why female physicians in USA gets on an average 20000 dollars less than male colleagues in a year.
But what does scientific data say ?
A new study published online in JAMA has some interesting results. As per the study female internists give better results than their male counterparts.
Doctor, can I use the new Ayurvedic medicine for Diabetes ?
A patient was asking me.
Which one ?
The one lauded by our Prime minster .
Oh , you mean BGR 34 ?
Yes.
Then better not.
Anticipating such questions, I had studied the molecule using resources at my disposal.
It is a mixture of four herbs. Individually these herbs had undergone small lab and clinical studies with mixed results. In February the Indian government’s Council of Scientific and Industrial Research (CSIR) has come out with a mixture of these four herbs in a single tablet amidst great fanfare with backing of just one unpublished study on 48 patients.
Finally some good news in the health front from South Asia. Sri Lanka became the first major country in the region to be declared malaria free by World Health Organisation.A country is declared free of malaria when it does not report any indigenous cases for three consecutive years.
In a remarkable public health achievement, Sri Lanka was today certified by WHO on having eliminated malaria, a life-threatening disease which long affected the island country.
“Sri Lanka’s achievement is truly remarkable. In the mid-20th century it was among the most malaria-affected countries, but now it is malaria-free. This is testament to the courage and vision of its leaders, and signifies the great leaps that can be made when targeted action is taken. It also demonstrates the importance of grass-roots community engagement and a whole-of-society approach when it comes to making dramatic public health gains,” WHO Regional Director, Dr Poonam Khetrapal Singh, said here.
Diphtheria is coming back with vengeance in parts of Asia where it had been well controlled. Malaysia and Vietnam has reported several cases of Diphtheria in last two months along with Kerala state in south India. There has been 5 deaths in Malaysia, 3 in Vietnam and 2 in Kerala. Both in Kerala and Malaysia, adults some as old as 65, are among suspected cases.
All three areas had similarly good control of Diphtheria for several years now , with only a handful of cases yearly and no deaths. In Malaysia and Kerala, religion based superstitions about vaccinations was found to be a major driving factor for poor vaccination coverage and there by reemergence of the disease. In Vietnam too, the propagation of myths about vaccines has reduced its acceptance.
This week-end saw medical students of Kerala’s medical colleges on a campaign trail. They were at the epicentre of anti vaccine campaign in the state, in the rural areas of Malappuram District.
They were at Tanalur, a place near Tirur. People here are fairly prosperous and well-educated. But they feel vaccines are bad for their kids. Here the percentage of children fully vaccinated was well under fifty percent. The families here used to close their doors at health workers who come to their homes urging them to vaccinate.
Some believe naturopath quacks when they say taking vaccines and preventing “harmless” diseases is anti nature. Others believe their political leaders who say vaccines are an imperialist conspiracy to produce sterility in the third world population. Many believe their religious scholars who tell them that Allah is giving complete protection from the womb itself and humans trying to usurp him is not only absurd but against “god”. There are also other allegations against vaccines like they are produced from pig meat and they result in paralysis and mental retardation. In several families, women who wanted their kids to be protected by vaccines had to face tough resistance from men.
Media in the state of Kerala, India, has reported prominently another vaccine preventable death in the state. A 15 year old boy from Malappuram district was the latest victim of the lethal mix of religion, conspiracy theories and pseudoscience. He died yesterday due to diphtheria.
Diphtheria outbreaks and deaths are not a big news in rest of India. India has 10-15 times more Diphtheria cases than any other country in the World. But it is news in Kerala state as it has comparatively much better health care record. Here in Kerala the diphtheria cases and thereby deaths are extremely rare in the last 10-15 years. Average annual incidence of diphtheria was around 10 cases in the whole of the state. But last two years saw a sudden spurt of cases from Malappuram and Kozhikode districts. There were also two deaths last year.
After smallpox another infectious disease may be eradicated in near future. This year there are only two confirmed cases of Guinea worm infection. If things go according to plan, this horribly painful infection will be confined soon to history books.
This eradication is in many way unique. There is no treatment for Guinea worm infection. There is no vaccine.. So the tools for eradication are health education and preventive measures. Scientific knowledge of the way it spreads and common sense approach to prevent it spreading was the key for the success.
Medical worker Abaare Hussein extracts a Guinea worm from a child’s leg in Savelugu Village in northern Ghana in 2007.
Wes Pope/Chicago Tribune/MCT via Getty Images
Doctor, we are not getting the anti AIDS drugs from government hospital. Can you somehow help?
I was asked this question in my clinic the other day.
Though I was surprised by that question, I was expecting such a situation ever since the Indian government announced big cuts in budgetary allocations for health in December 2014. Situation is becoming bad not only for AIDS program but many other public health programs.
Volunteers of National Service Scheme (NSS) pose with HIV/AIDS awareness messages on their faces during a face painting competition ahead of the World AIDS Day in the northern Indian city of Chandigarh November 29, 2014. REUTERS/Ajay Verma