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Thursday 2 May 2013

Empire of maladies: What ails urban India

The northern and southern most states of the country are facing some trouble in their head and heart. Over 55 per cent of the population suffers from some form of mental trauma in Kashmir, owing to decades of political turmoil. In Chennai, the prevalence of Coronary Artery Disease — one of the leading causes of death globally — is 11 times higher today than it was in the 1960s. And there we have it. Though middle class, urban India growing at a phenomenal rate (in three years, there'll be 53.3 million such households), invests generously in the wellness industry — pegged at Rs 49,000 cr — the rampant lack of well-being in our cities is surprising. Mirror spoke to researchers, doctors and residents across India to examine this disconnect, and ask them a simple question — what ails us and why? The answers were wide-ranging. Some connections, such as that between oral cancer and tobacco were apparent, others like the one between air pollution and infertility we wouldn't have guessed. In each case, however, experts stressed that while solutions are at hand, implementation through improved healthcare facilities and individual care is needed
This is not an exhaustive list. Conditions like HIV/AIDS, other forms of cancer, and genetic disorders like Thalassemia, haven't been included. It's not that they aren't significant, but instead point to the fact that we have much to be concerned about. As you read this, the 12th Five Year Plan, for 2012 to 2017 is being drafted. Volume 3 of the draft tackles health, and offers an overview of the current situation — 53% deaths are caused by non-communicable diseases like malignant cancers and diabetes, 37% are caused by communicable infections. The draft recommends that greater effort be made at involving the community in planning, monitoring and delivering health services. That's what we hope to do — after all, Mirror cares for both, the head and heart.
Maharashtra at risk: 25 people per one lakh Maharashtrians have oral cancer
Cause: Tobacco
Chewed up by cancer
Nine years ago, 47-year-old Kalyan resident Vijay Kumar Prasad, a seller of kitchen utensils, gave up tobacco. "I saw my friends do it, so I tried it, too. I travelled for business, and chewed tobacco for recreation. Before I knew it, I was addicted," he says. Two years after quitting, he was diagnosed with oral cancer. During a check-up at St George Hospital, the doctor suspected Prasad had cancer. A biopsy at Tata Memorial confirmed his suspicion. "Fate pulled a fast one on me. Har ek ka luck hota hai, mera kharab nikla," says Prasad.
He underwent a surgery which left the right side of his jaw permanently disfigured. He now struggles to eat and speak. A father of two young daughters, Prasad says awareness of tobacco's consequences must be drilled into the common man. "Pictures should be put up at every bus stop and railway station. Only then can we begin to think of tackling this menace."
According to data provided by registries of the Indian Cancer Society, India accounts for 86% of the world's oral cancer cases. A study conducted by the National Institute of Public Health in 2011 reveals that 90% of these cases are due to chewing tobacco in the form of gutka, quid, pan masala, snuff, or misri (in the West, smoking is the main cause). Oral cancer is the most common cancer in India — four in 10 cases of cancer are oral. In Maharashtra, it is showing an increasing trend. "Its incidence among the youth is increasing in the state, which has one of the highest incidences of tobacco consumption. Every third Maharashtrian and every second male does it. We also have the largest cigarette and bidi smoking population in the country, which is why it is not surprising that 25 people per one lakh Maharashtrians have oral cancer. The second biggest cause is supari which, though is a confirmed cancer-causing substance, is still considered acceptable in most social scenarios," says Dr Pankaj Chaturvedi, head and neck cancer surgeon of Tata Memorial Hospital.

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