Health Care in India- Myth or reality: Are we ready for the big transformation ??

We are a country of 1.25 billion plus population out of which approx 88cr are living in the rural areas & urbanization has touched a mere 37cr people. Unlike western countries we have a huge gap between both the settlement. Even though it would be inaccurate, if we presume all these urban citizen lives a very good life. In a lower middle income country like ours, Cities are also having challenges of their own, in many cases people are even deprived from the basic amenities like food, shelter, health & hygiene.   

Being part of relatively educated mass, It's always quite captivating, when I read, we are the 7th largest economy (in terms of nominal GDP) & our GDP growth will surpass china soon. I don't understand whether these figures are  compelling enough to give a smile in the face of that poor man who resides in the remotest corner of  our country with sub 1$ income.

Out of all the essential indicator, healthcare is pivotal. We are the 3rd largest pharmaceutical market in terms of volume & 14th largest in terms of value. India is known for its cost-effective medical tourism & home to highly skilled medical professionals.  Despite all these clamour we are 112 in the WHO ranking for healthcare system globally. This evident because one million Indians die every year due to inadequate healthcare facilities and close to 700 million people have no access to specialist care.

Inadequate Healthcare Budget : 

The Indian Govt spends 2.27 % of GDP on healthcare where as it's approx 8-9% for developed countries.India’s healthcare spending is the lowest among BRICS (Brazil, Russia, India, China, South Africa) nations,. Even neighbouring countries like Pakistan(2.6%), Srilanka (3.5%) spends more on healthcare.  

It was noted that India spent about $40 per person annually on health care where as the United States spent $8,500. The entire GDP of India was $1.8 trillion then while the US health care spending alone was $2.6 trillion.

  

Govt. Infrastructure:

The problem essentially lies with government hospitals and their poor infrastructure. While there are many universal health care schemes being run by the Central and the State Governments in India and the government hospitals offer treatment and essential drugs free of charge, the fact that the government sector is understaffed, underfinanced and that these hospitals maintain very poor standards of hygiene forces many people to visit private medical practitioners and hospitals.

Niti Ayog Report of 2015, based on a survey, showed that around 41% of anganwadis have inadequate space, 71% are not visited by doctors, 31% have no nutritional supplementation for malnourished children and 52% have bad hygienic conditions.

Insurance Penetration:

While the insurance penetration is quite high in most of the developed nation , In India’s healthcare industry lack of a medically insured population and have high no's of patients who spend out-of-pocket (about 71 per cent of the total health care expenditure in the country was borne by households ).

Shortage of HCP:

Our doctor-patient population ratio of 1:1,674, worse than Vietnam, Algeria and Pakistan. India is falling short of 500000 doctors.

Public-health centres across India’s rural areas–25,308 in 29 states and seven union territories–are short of more than 3,000 doctors, the scarcity rising 200% (or tripling) over 10 years.

Lowest Bed/ Patient ratio:

India has only 1.1 beds per 1,000 population compared to the world average of 2.7 bed per 1,000  . 70% of India’s healthcare infrastructure concentrated in the top 20 cities. Hence there is a huge opportunities need to be uncover in the Indian healthcare Industry. Corporate India is already sharing a huge patient load  due to lack of infra from the govt. side . There should be certain alternative need to be developed to bridge the gap in healthcare segment.

Suggestions:

Priority Sector Tag:

Healthcare should be given a priority sector tag (currently, agriculture, MSMEs, export credit, education, housing, social infrastructure, renewable energy and others have been given this status) .This will help channelize funds from the banking sector to create necessary healthcare infrastructure

Development of healthcare specific PPPs:

Tax incentive, low interest, import duty wave off & Scaling up PPPs in the healthcare sector will require. Effort to standardise concession agreements and collateral and exit clauses. Private sector should be encourage to establish more centres in tier 2 -3 cities with viable economic models.

Health care fund :

A fund similar to the provident fund should be introduced for salaried employees .It could be also used to pay for outpatient services and preventive health checks .Investments into this fund could be tax deductible under section.

Foreign Investment:

The healthcare sector has been benefited with a good no of green & brown field projects  over last couple of years. The govt should encourage more on this & also huge incentive should also be given for setting up health care facility in tier 2-3 cities.

Mandatory Rural Posting:

Mandatory rural posting for at least 5-10 years should be imposed on healthcare providers. It could also be linked with their appraisal. However it would be unfair if the govt will be doing same without creating basic infrastructures ( Housing/ Electricity/ Quality education for their kids/ Transportation).

Though the govt initiatives like Pradhanmantri Swastya suraksha Yojna, Universal health cover are few good initiative in this  direction but we need to take more time bound & result oriented initiative to reduce pain of  burgeoning patient population of our country.

V Treat Foundation Day Celebration

We could not even realized when this 1 year has passed. The journey which has started exactly 1yr back has started getting momentum. Its because of all your love, good wishes & collaboration. Many people in this 1 year associated & many could not continue because of some other priorities. However I would like to be thank full to all of you for your continuous support. 

Lets celebrate our first year of establishment on 1st May. As it's also International labour day so hope many of you must have holiday. So please spare some time & be a part of this journey. It's basically to spare some time with all you guys & know each other better. So that we will have a mutual trust & belonging when we all move forward. The cost of the lunch is approx Rs. 550-600 which we will try to negotiate & individual have to pay for their own. So see you guys. 

Those who are interested can directly reach me on 9640056585 or Mohan 9966006760. Those who are interested to coordinate for the event are also most welcome.

D.T.S ( Donate To Save) Anjuman High School, Musheerabad

D.T.S ( Donate to Save) an initiative from V Treat along with Thalassemia Society & Lions Club ( Kukatpally, Secunderabad & Suraram) to arrange blood for Thalassemia affected Kids with no cost . These kids requires frequent blood transfusion, few even require transfusion every week. Many of them couldn't afford the cost as blood is not freely available & very expensive to purchase every week. So V Treat invites all the citizen to be part of this initiative. Your blood can save somebody's life.

For More Information on V Treat & It's activity please visit

How to increase Hemoglobin level in Body??

I would like to thank all the volunteers who came forward to make Project D.T.S successful. It's quite encouraging to have few women who had showed their courage & turned up to the center to donate blood. However it's low hemoglobin & low BP because of which few couldn't donate, but their courage is most welcoming. I hope with a better diet, exercise & little beat of life style improvement they will be the eligible donors for our next blood donation camp.

Low hemoglobin level is quite common among women in India & emerging countries, there might be multiple factors like pregnancy, menstruation, in proper diet, etc are the reason for low hemoglobin level. However its quite important to maintain a good hemoglobin level because it gives us the required energy & make us charged day long.

The required hemoglobin level for men should be between 14-18 dL & for women 12-16 dL. Below is a very useful video on the various kind of foods that we should take in our daily diet to wipe out hemoglobin deficiency.

D.T. S (Donate To Save) Kondapur Area General Hospital ( 02/04/2017)

We would like to extend our gratitude to all the volunteers who came forward to make this program successful. Also we are thankful to the superintendent of Govt. Area Hospital Dr. Prabhakar for allowing us to conduct the blood donation camp at the hospital premises. My special regards to Thalassemia society of Hyderabad & their team for organizing the event systematically. Also we would appreciate the effort undertaken by thalassemia society for taking the toil to provide free blood transfusion for thalassemia affected kids. Thank you very much to all of you once again.

D.T.S ( Donate To Save) Knowing Thalassemia Part-4

As of now we got some basic information on diagnosis, causes, symptoms & complication arises due to Thalassemia. This is the last issue of this series & here we have tried to highlight the available treatment for the Thalassemia affected kids.

The treatment mainly hovers around the severity & type of thalassemia. However prevention is the best medicine. If we there will be an awareness on genetic counselling occurred before marriage & before pregnancy then this disease can be avoided to a great extent.

People with mild to moderate thalassemia in alpha & beta category generally require no treatment or very less treatment. However people with moderate to severe thalassemia require aggressive treatments.

Basically the treatment part for thalassemia is divided in to 2 ways .

1. Palliative Treatment
2. Curative Treatment

Palliative Treatment: These types of treatments basically designed to relieve symptoms & improve quality of life of patients. It could be used at any point of time of the illness. This type of treatment is basically of 4 types.

• Blood Transfusion: People with mild to moderate thalassemia generally goes for this therapy. Every seating generally is of 1-4 hrs & repeated every 120 days. This is because life span of RBC is of 120 days. Blood transfusions allow you to feel better, enjoy normal activities, and live into adulthood. This treatment is lifesaving, but it's expensive and carries a risk of transmitting infections and viruses (for example, hepatitis).

• Iron Chelation: This is basically a process to extract excessive of iron from the body. These excessive iron got deposited due to frequent blood transfusion. Excessive iron damages the liver, heart, and other parts of the body

• Folic acid supplementation: Folic acid  basically helps to build healthy red blood cells. Hence it is recommended along with the blood transfusion.

• Splenectomy: It's basically surgical procedure to remove the spleen. Patients with high rate of transfusion may require to undergo this therapy.

Curative Treatment: These types of treatment are more scientific & used to wipe out the disease from the body. These are relatively expensive & painful. 

• Bone Marrow Transplantation: Bone marrow is the factory where blood is being produced. Through this procedure the existing bone marrow is being replaced with a donor bone marrow ( Alogenic). A stem cell transplant is the only treatment that can cure thalassemia. But only a small number of people who have severe thalassemias are able to find a good donor match and have the risky procedure.

• Genetic Therapy: Scientist are working on various newer technique to treat Thalassemia. Research has gone to the genetic & molecular level to find out the solution for Thalassemia. it might be possible someday to insert a normal hemoglobin gene into stem cells in bone marrow. This will allow people who have thalassemias to make their own healthy red blood cells and hemoglobin. 

D.T.S ( Donate To Save) Knowing Thalassemia Part-3

The previous article was about the diagnosis & symptoms of Thalassemia & this one is, about the symptoms & the complication of thalassemia. The symptom widely differ depends upon the severity of the disease.

Symptom of Thalassemia:

Haemoglobin is known as oxygen carrier in the blood. In most of the thalassemia patients deficiency

of haemoglobin result in poor oxygen level in the blood. That make the thalassemia patient condition worrisome.  Depending upon the type of thalassemia ( Major/ Minor) symptoms become weak or strong.

i) No Symptoms

Alpha thalassemia is silent carriers generally have no signs or symptoms of the disorder. The lack of alpha globin protein is so minor that the body's hemoglobin works normally.

ii) Mild Anemia

People who have alpha or beta thalassemia trait can have mild anemia. However, many people who have these types of thalassemia have no signs or symptoms.

Mild anemia can make you feel tired. Mild anemia caused by alpha thalassemia trait might be mistaken for iron-deficiency anemia.

iii) Mild to Moderate Anemia 

People who have beta thalassemia intermedia have mild to moderate anemia. They also may have other health problems, such as:

·    a) Slowed growth and delayed puberty. Anemia can slow down a child's growth and development.

·    b) Bone problems. Thalassemia may cause bone marrow to expand. Bone marrow is the spongy substance inside bones that makes blood cells. When bone marrow expands, the bones become wider than normal. They may become brittle and break easily.

·         

     c) Enlarged spleen. The spleen is an organ that helps your body fight infection and remove unwanted material. When a person has thalassemia, the spleen has to work very hard. As a result, the spleen becomes larger than normal. This makes anemia worse. If the spleen becomes too large, it must be removed.

iv) Severe Anemia:

People who have hemoglobin H disease or beta thalassemia major (also called Cooley's anemia) have severe thalassemia. Signs and symptoms usually occur within the first 2 years of life. They may include severe anemia and other health problems, such as:

• ·         A pale and listless appearance
• ·         Poor appetite
• ·         Dark urine (a sign that red blood cells are breaking down)
• ·         Slowed growth and delayed puberty
• ·         Jaundice (a yellowish color of the skin or whites of the eyes)
• ·         An enlarged spleen, liver, or heart
• ·         Bone problems (especially with bones in the face)

Complications of Thalassemias

Better treatments now allow people who have moderate and severe thalassemias to live much longer. As a result, these people must cope with complications of these disorders that occur over time.

Heart and Liver Diseases:

Regular blood transfusions are a standard treatment for thalassemias. Transfusions can cause iron to build up in the blood (iron overload). This can damage organs and tissues, especially the heart and liver.

Heart disease caused by iron overload is the main cause of death in people who have thalassemias. Heart disease includes heart failure, arrhythmias (irregular heartbeats), and heart attack. 

Infection:

Among people who have thalassemias, infections are a key cause of illness and the second most common cause of death. People who have had their spleens removed are at even higher risk because they no longer have this infection-fighting organ.

Osteoporosis:

Many people who have thalassemias have bone problems, including osteoporosis. This is a condition in which bones are weak and brittle and break easily.

Contd....

Source: www.nhlbi.nih.gov

D.T.S ( Donate To Save) Knowing Thalassemia Part-2

I hope the story of Rohan published in our previous article might have threw some light on what Thalassemia is all about & few basic statistics on the condition of Thalassemia in our country. In this series we are going to discuss on the Diagnosis & cause of Thalassemia.

Diagnosis:

1) Prenatal Stage:

With the advancement in medical science its very much possible to diagnose any deformity in the new born during the prenatal stage by conducting the simple genetic testing. If both the parents or any one of them are carrier then there is an increased risk of the Thalassemia in the new born. Hence its always advisable to take the help of genetic counselor to know the risk of passing on this disease to the kid especially when any one of the parent is a carrier.

2) Blood Test:

CBC (Complete Blood Count) measures the amount of hemoglobin and the different kinds of blood cells, such as red blood cells, in a sample of blood. People who have thalassemias have fewer healthy red blood cells and less hemoglobin than normal in their blood. People who have alpha or beta thalassemia trait may have red blood cells that are smaller than normal.

Hemoglobin tests measure the types of hemoglobin in a blood sample. People who have thalassemias have problems with the alpha or beta globin protein chains of hemoglobin.

3) Based on Severity:

Moderate and severe thalassemias usually are diagnosed in early childhood. This is because signs and symptoms, including severe anemia, often occur within the first 2 years of life.

People who have milder forms of thalassemia might be diagnosed after a routine blood test shows they have anemia. Doctors might suspect thalassemia if a person has anemia and belongs to certain ethnic group.

Causes of Thalassemia:

Genetic: Thalassemia is basically a genetic disorder which happens because of genetic mutation.  When both the parents are carrier of thalassemia there is an increased chance of Thalassemia to their offspring.  On the other hand if one of the parent is a carrier of Thalassemia then it's quite possible that the offspring might be having Thalassemia minor where the offspring  won't exhibit any major symptoms.

Ethnicity: According to the Center  for Disease Control (CDC), thalassemia is most common in people from Asia, the Middle East, Africa, and Mediterranean countries such as Greece and Turkey.

Contd......

Source: www.nhlbi.nih.gov/www.healthline.com

All About Thalassaemia - Cartoon

A beautiful illustration through comic characters on What Thalassemia is & how it affect our body. Must Watch for a basic level understanding on the disease. 

D.T.S ( Donate to Save ) Thalassemia Awareness Series

I Met Rohan* the 5 yr old Kid affected with Thalassemia major, who is being dependent on the regular blood transfusion for his very own survival.

Every time he look forward for a donor who can save his live. To sum up his life is in a mercy of some one who can give blood. Being from the middle class background it's becoming very difficult for his parents also to arrange blood  every time.

There are 1000's of Rohan who struggle every day for a pint of blood to make there very existence in this planet. This is a story of every kids diagnosed with Thalassemia.


Few Facts on Thalassemia: 

• India & South East Asia genetically predisposed to have Thalassemia.
• India is considered as Thalassemia Capital of the World.
• More than 8000 birth takes place every year in India with thalassemia some of who requires blood transfusion as early as 6 months.

As an initiative of D.T.S we at V Treat trying to build the awareness on Thalassemia through a series of blogs, where we will cover every aspects of Thalassemia & the current situation in our country. Also we are trying to build a largest pool of donors who will come forward to help these needy kids. 

What is Thalassemia:

Its a genetic disorder & it's affected a group of blood cells.

As all of us know Hemoglobin is the oxygen career in blood so it plays a vital role in the entire circulatory system. Its comprises of 2 different types proteins viz. alpha & Beta. If the body doesn’t produce enough of either of these two proteins, the red blood cells do not form properly and cannot carry sufficient oxygen. The result is anemia that begins in early childhood and lasts throughout life. 

Since thalassemia is not a single disorder but a group of related disorders that affect the human body in similar ways, it is important to understand the differences between the various types of thalassemia.

Broadly these are divided in to two categories 

1. Alpha Thalassemia
2. Beta Thalassemia

In addition to the alpha and beta thalassemias, there are other related disorders that occur when the gene for alpha or beta thalassemia combines with an abnormal or mutant gene.

1. E Beta Thalassemia
2. Sickle Beta Thalassemia.

We will discuss in details about these in the subsequent blogs:

Do visit us for more information on Project D.T.S & V Treat Foundation on (www.vtreat.org) also join us in meet up( https://www.meetup.com/V-Treat-Foundation-Hyderabad-Chapter/)

Souce: https://www.slideshare.net/NarayanaHealth/facts-on-thalassemia-disease

https://en.wikipedia.org/wiki/Thalassemia

http://www.thalassemia.org/learn-about-thalassemia/about-thalassemia/

Disclosure: Name changed photo taken from google

Project D.T.S ( Donate To Save)

Friends we at V Treat Foundation are conducting a blood donation camp in collaberation with Thalassemia Society Hyderabad on 2nd April 2017 in  Kondapur for  Thalassemia affected kids. Blood collected in this event will be used for transfusion in  kids free of cost. If you have frnds near & dear one in Hyderabad please let them know to make this event success. you can revert back on contact@vtreat.org or  ping me on 9640056585 or visit us in www.vtreat.org or our Meetup site https://www.meetup.com/V-Treat-Foundation-Hyderabad-Chapter/events/238511455/

Blood Donation Camp for Kids affected with Thalassemia

V-Treat Foundation in collaberation with Thalassemia Society Hyderabad conducting blood donation camp @ Govt. Area Hospital Kondapur. The blood donated will be taken by Thalassemia Society of Hyderabad & will be used to transfuse in the kids who require blood transfusion very frequently. For more details Please contact the below no : 9966006760,9640056585

Project V.I.B.E ( Miles to go before we Stop...)

Heii Friends, Wish you all Happy Makar Sankranti from V Treat Foundation!!

We would like to write the  1st blog of the FY-17 to share our experience in Munganur village during project V.I.B.E .It was a breast cancer screening camp conducted on 8th jan 2017 at Munganur village of Hayathnagar.

On 7th evening after talking to the organiser Vijayalaxmi mam, our optimism made a nose dive, when she told it's Vaikunth ekadashi tomorrow & the village people may not turn up because of the festival. Though we were disappointed on her comment for a while still we  decided to go ahead with our plan. 

We reached around 8 AM in the village & planned for our campaign . We were segregated in to 3 group . Our special thanks for Harsh & Ganesh & Bramhaji, who extended their help as volunteer to make this event success. 

It was very 1st time for us also to conduct a medical camp. I along with Ganesh went door to door like an election campaign & explaining every family regarding the event. Even we approached the village priest, who had helped us to intimate the villagers regarding the event from  the temple mic. I was surprised to see this kind of cohesiveness among the  villagers, . Anyway by 9;AM, we had visited almost all the houses. The announcement from the local pandit Ji was also adding fuel to the activity.

"I dont have CANCER" "Why I should get CANCER" "We never smoke in life we won't be getting cancer"

Are you wondering about the above statements!!! These are few of the statements uttered by the villagers, when we were requesting them to attend the screening camp. Initially I didn't think much on the statement but later when I analysed these statements from the villagers then I was feeling really pity. As the statistics also saying in India 60% cases of cancer diagnosed on the late stage, which make the treatment  more complex & cure rate further less.

"Ignorance is the biggest enemy for all of us ", Probably today Cancer is one of the deadliest disease on the planet & it doesn't select people based on the caste, creed & colour. In  India around one million new cancer cases are being diagnosed in India each year, projected to nearly double to 1.7 million new cases in 2035.

Around 700,000 people are dying from cancer in India annually, The projected figure is to rise to around 1.2 million deaths in 2035.  Among Indian women Breast & Cervical tend to be the most common type of cancer. While 1 in every 5 women diagnosed with breast cancer, for cervical it's 1 woman dies every 7 minutes in India. It's quite alarming. So being a responsible citizen, its our  moral responsibility to educate people, so they can take care of their health & society.



Project V.I.B.E ( V Treat Initiated Breast Examination) is an initiative from V Treat to educate & inform the women of our country on cancer, so that they can take care of the entire family as well as of themselves. It's just a beginning, we know we have a long way to go. If we can reach at least 50% of the woman of our mission will be successful.

Being the 1st camp we got a lot of learning from not only from the villagers but also from the medical fraternity. We are pretty sure with the collective feedback our next camp will be more organised & we will be able to avoid the mistakes that we did in the last event.

 We would like to extend our special thanks to doctors from KIMS BIBI & Yashoda to spare time, out of their busy schedule to make this event success. Total 69 subjects were screened & few were detected some minor anomaly. Doctors from both the institute has advised free medication & check up for further round of examination. I would like to extend my gratitude to all those people who are being associated with V Treat & expect lots of participation on our up coming activities.