CRISIS OF RURAL HEALTH
Most of India’s people, and most of its poor, still live in rural India. The burden of disease and its effects are disproportionately seen among the poor, with a clear gradient in illness and mortality between the lower and middle classes. This rural health crisis is becoming more complex and tenacious and is worsening the quality of life in rural India.
A 2002 study in Bilaspur found that 41% of men and 43% of women had a BMI (body mass index) of less than 18.5. People with a BMI under this threshold are considered to be underweight.
The consequences of low BMI include poor work capacity, which leads to lower income, which in turn leads to less food to eat and a lower BMI. Individuals with low BMI also fall ill more frequently, and mothers with low BMIs have smaller babies. Almost 65% of our children below the age of 5 years are undernourished.
Malaria is a major problem of the tribal areas of India. 50% of all malaria cases, 70% of all Falciparum malaria cases, and 90% of all malaria deaths occur in tribal areas.
The high incidence of malaria in tribal areas is due to a variety of factors. Standing water in streams, ponds, rice fields, irrigation projects, and even hoof prints around water pumps provide breeding grounds for mosquitos. Many people cannot afford personal protection measures, such as repellants and nets treated with insecticide.
There is also a lack of early, rational treatment.
Tuberculosis is the most common killer of young people in rural Bilaspur. It is unfortunately not unusual to see many people in a family affected by the disease due to close contact and a shared status of malnutrition. A recent survey of the scientific literature as well as our own experience have shown us the devastating role hunger can play in tuberculosis. Undernutrition is a frequent cause of immunological suppression, far more than HIV-AIDS and diabetes.
SNAKE AND ANIMAL BITES
Snake bites are common in most rural areas, particularly in forest and forest fringe villages. Deaths due to poisonous snake bites are a major cause of death in our area despite being highly preventable.
While anyone can be at risk for health complications during pregnancy, the danger is particularly high in rural areas where poverty and malnutrition are rampant, women start having children at incredibly young ages, and the number of pregnancies for an individual woman is often in the double digits. On top of the already high risk of health issues that these women face, they live in remote villages that can be hours away from a functioning health centre.
Some common issues we see in our pregnant patients include anemia, infections, malaria (falciparum malaria can be highly lethal in pregnant women), pre-eclampsia and eclampsia.
Thanks to Tom Pietrasik for photographs of JSS