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Professor BM Hegde
A former professor of cardiology, Middlesex Hospital Medical School, University of London and former Vice-Chancellor, Manipal University | India is more than a country. It is a vast subcontinent with diverse ethnic, religious and social classes of people living in harmony. This is a perfect example of unity in diversity. However, the bane of the Indians is the poverty level among the rural masses. While there are large numbers of people who are very rich in India, some of them even making it to the Forbes Fortune list, the majority does not know where the next meal comes from. Poverty is the womb of all diseases. Origin of Diseases Diseases originate in the human mind. The greatest stress for man is not knowing where his next meal will come from; and the next most important cause is intense fear. The gulf between the haves and the have-nots is widening by the day in India, as well as every part of this universe. Whereas the poor, even in the rich countries, do not know where their next meal comes from and suffer from killer diseases, the rich, on the contrary, live in intense fear of the poor. It is the poor who form the bulk of terrorists, muggers, car-jackers, murderers, robbers and other anti-social elements. The rich, therefore, suffer from degenerative diseases, basically because of the intense fear and frustration. Healthcare in India Post-Independence  When the British left India in 1947 without any blood shed, they left behind abject poverty in the country, having looted it for well over two hundred years. Resurgent India inherited this very low-income group of people whose life expectancy at that time was just about 27 years. It is heartening to note that it is nearing 70 years today. The country has progressed very well. The foreign exchange reserve has crossed an all time high and today stands at $80 billion. India is the first country to have prepaid a large part of its loan and has now declared that it does not want loans from any nation. India has already come forward to give loans to small countries. But the gulf between the rich and the poor has widened, leaving behind large parts of the country in poverty. The overall picture looks good, in that the sanitation and the food position have improved dramatically. This is the main reason for the rise in the life expectancy. Common belief is that doctors, hi-tech hospitals and, modern drugs are the cause of health improvement. This reminds one of Oscar Wilde who said, "Lies are the truth of other people." This myth that modern, hi-tech medicine is the cause of health improvement of the common man is the biggest lie that the drug and the technology lobbies want the public to believe.
Factors for Improving Healthcare Be that as it may, health improves only with basic amenities being given to people, but India still needs to go a long way, very long way indeed, to make its masses healthy. Even today 70 per cent of the children have less than 50 per cent hemoglobin because of rampant hookworm infestations in the rural areas. Malnutrition and diarrheal diseases take a very heavy toll on human lives, basically because of the lack of clean water supply to villages. A recent UNIDO report noted that the developing world would have to concentrate on four fundamental aspects to improve the health levels of their masses: - Clean drinking water for all
- Three square meals a day uncontaminated by human and/or animal excreta
- Preventing cooking smoke from coming into the house. This kills children below the age of five through pneumonia and women through lung cancers and heart attacks.
- Economic empowerment of women in the village so that they would be able to feed the hungry kids when the husband comes home drunk having spent all the money for alcohol. For any mother the greatest health risk is seeing her own kids go to bed on empty stomachs.
Poverty kills people even in developed countries. A recent report in Ireland showed that in one year nearly 6000 people died basically because of poverty in that country. Indian healthcare: At Par With the Western World The present state of affairs, vis-a-vis medical care delivery in India, could be compared to any developed country in the world. However, that does not mean that the health of the Indian masses has kept pace with the developments in the curative modern medical field. The hi-tech medical facilities in India are as good, if not better than, many of the advanced western countries. Increasing the number of doctors per population and increasing the number of hospitals has nothing to do with either life expectancy or mortality. Across the industrial world, the numbers prove my point. United Kingdom has only 160 doctors for a population of 100,000. Italy, on the contrary, has thrice that number (thrice as expensive also) but the life expectancy is almost the same, slightly better in the UK. This is no fluke. Ireland and Japan have around 200 doctors per 100,000 population while Belgium and Switzerland where there are 400 and 320 respectively. Life expectancies are the same in all these four countries. Modern medicine has become a business these days and doctors are easily brainwashed by the drug and technology lobbies to do what they want them to do. When doctors went on strike in Israel recently death rate came down significantly. Similarly in Bogota, Columbia, Los Angeles County about ten years ago and, Saskatchewan in Canada 15 years ago, during strike periods death and disability rates fell down significantly! Lately drug companies have been creating new diseases to sell their drugs; it is called as 'disease mongering'. Resolving the Myth of Modern Hi-tech Medicine Now it would become clear to anyone that modern hi-tech medicine is not a panacea for human ills. However, modern medicine is definitely a boon to the suffering humanity as it could "cure rarely, comfort mostly, but console always," in the words of the father of medicine, Hippocrates. The problem with the present modern medicine is that it claims to do good to healthy people by changing their body parameters, even when they are healthy. This 'doctor-thinks-you-have a disease' syndrome is the bane of modern medicine. Time evolution in the human body does not follow linear rules. Changing the initial state, partially with drugs or surgery, in healthy people, might not hold good as time evolves. In the long run, all interventions in healthy people result in higher deaths and disability. This is the reason for the fall in death rate when doctors do not interfere with healthy peoples' lives. The medical profession, along with the drug lobby, has turned even an advanced nation like the US into a nation of hypochondriacs! This is just to make big money. The screening industry is another big fraud on the public. Doctors have been predicting the unpredictable all these years, thereby making everyone anxious. "The problems lie in medicine's difficulty in defining normality, the devil of false positives and their poor understanding of time evolution and natural history of diseases. We will be screened for every kind of cancer.....It is always hard to put a case for not knowing, but economists-cold hearted beasts that they are-have a wonderful notion of rational ignorance" writes Dr. Richard Smith, the editor of the British Medical Journal in his editorial – 'Ignorance can be bliss'. The Case of 'Inverse Care Law' More than 80 per cent of Indians (80 per cent of world population also) live without any influence from modern medicine. So far so good! There is another side of the coin that must be made known in this context. In India we have a mix of the good, bad and the ugly even in the field of human health. Whereas the life expectancy of a new born child in the southern state of Kerala and, in my own district of South Kanara, is as good as that of a child in Europe today, the picture in north Indian states is bad, the life expectancy being around the level of Sub Saharan Africa. This shows the distribution of literacy levels as also the poverty standards. Despite all these the health expectancy of an average Indian is very high compared to the advanced west. Many of our able bodied villagers would not have seen doctors all their lives and some of them, the ratio might be the same elsewhere, are centenarians! The highest incidence of diseases is seen in the poor population of the villages while the large number of specialists and sub specialists are seen in large cities. This kind of disparity exists even in the west. A thinking senior doctor of Wales, Julian Tudor Hart, calls this the inverse care law. Health promotion, otherwise called the wellness concept, is the future scenario for keeping the well healthy by change of mode of living with hea | 
