Health Matters | Doctors do much

This week in health: the false promises of BMI, crack down on Indian drug makers and why young adults are populating the dark web.

Updated - July 05, 2023 02:24 pm IST

Published - July 04, 2023 01:10 pm IST

Image for representational purpose only.

Image for representational purpose only. | Photo Credit: The Hindu

(In the weekly Health Matters newsletter, Ramya Kannan writes about getting to good health, and staying there. You can subscribe here to get the newsletter in your inbox.)

Another Doctor’s Day has just gone past (July 1), a day to celebrate the work that doctors are taught to do. In a country like India, there are many variables that can be frustrating: the sheer volume of people who come in for care, their ability to pay or continue the treatment, the quality of infrastructure at the health centres, the advanced nature of the disease they come with when they are finally forced to seek treatment for. Not to mention the anger of a mob, if an unfortunate event or complication were to occur in the process. Indeed, many vicissitudes lie in the path of doctors, as does the unparalleled satisfaction of saving a life, or freeing someone from pain or discomfort. The ability of the people of this country to put doctors on a pedestal, deify them also seems to predispose them to violence against healthcare workers if things fail to go their way. The stabbing and death of a young house surgeon Vandana Das at a taluk hospital in Kollam, Kerala, in May last year, might have itself been an outlier incident, but crime columns are replete with instances of attacks against doctors or hospitals, not just this assault that happened on July 1 at Ernakulam. 

In a survey conducted at Thiruvananthapuram Medical College, it turned out that two out of every five doctors had experienced some form of aggression or violence at the workplace in the last year alone. Shockingly, this comprised verbal abuse (nearly 54%), verbal threats (40%), intimidation (27.8%), physical violence (5.7%) and cyberbullying (nearly 5%). Violence was experienced more by those in the government sector (84%) than those in the private sector (68%). 

Not that there is just gloom and doom on that front, let’s record the deification aspect as well. People do have great regard for doctors and the work they do, tending to treat some of them as they would their gods, like they do for this doctor in Suryapet. May their tribe increase.

Coming back to a staple of this column — non-communicable diseases. Speaking at a press conference, last weekend, a team of experts, including doctors at CMC Vellore made the point that policy changes to make healthy food cheaper are the need of the hour to tackle the diabetes epidemic. On the basis of two papers published in The Lancet seeking to establish the global inequity in diabetes, doctors said foods high in carbohydrates were cheap, whereas food that is high in fibre, and therefore healthier, are more expensive, making this one of the factors driving diabetes and pre-diabetes number up in India. While this is intuitive, there is a parallel with the United States where junk food being available cheaper led to rising numbers of diabetics among the poor, Black population that could not afford healthier food.   

Simultaneously looking at what has come to be seen as a measure of health, the BMI might quite not be what it is supposed to be. At its best, BMI clumsily threads the needle between obesity and mortality, mistaking correlation for causation: people who are obese have a high BMI, but it is not necessarily true that a high BMI implies obesity. Simpler measures such as also measuring body fat and waist circumference, particularly in an Indian population set have been recommended. 

It’s not as if society has evolved to leave all the bugs behind, buried or eliminated; in fact, the new emergence of cases in hitherto unaffected areas continues to be a source of worry for public health managers across the world. Which is why, this unexpected surge of cases of malaria in the United States is worrisome. Not surprisingly, climate change is cited as one of the reasons, creating as it does, warmer than usual climates. Similarly, Kerala’s doctors have expressed concern over the rise in influenza-related encephalitis in children in the State. 

Also, if concerns about heat-related ailments, homeostasis and what happens if that goes for a toss, affecting the ability of the body to regulate the heat, are issues that concern you, do listen to our podcast. Do remember, that heatstroke is a common-enough complaint, but if not tended to, can be fatal, as India has recorded this summer. 

Meanwhile, the movement to tackle antimicrobial resistance, got a fillip as the World Health Organisation recently set the global research agenda for AMR in human health, and prioritised 40 research topics for evidence generation to inform policy by 2030. Hopefully it will have an impact on the availability of life-saving antibiotics for low and middle income countries as well.

A tail note on another infectious disease, one that will COVID-19, in case anyone was under the mistaken impression that it is past. In addition to heart-related complications occurring during the course of COVID-19, an increase in the frequency of cardiovascular events has been noted for several months following the infection. 

From the Health pages

Do check out these stories:

IISc project looks at the possibility of using smartphones for the early detection and diagnosis of neurodegenerative diseases.

Curious about why Indian drug makers are under the lens? Find out the details, here.

Apparently, the use of dark web for drug purchases seems to be more popular among young adults aged 25 to 34.

The latest World Drug Report 2023 on the prevalence of opioid use disorders in India. 

Yet another use of technology, this time, to track the Amarnath yatris’ health

As always, do put us on your radar, as we bring more health content your way. Get more of The Hindu’s health coverage here.

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