No man is an island, and just keeping oneself healthy is not enough. We all live in society, but most of us still neglect the importance of ensuring healthy surroundings, so that it is common to find a house which is clean and sparkling inside, with all the garbage tossed outside the door or window! However, all of us pay the price for dirty and unhygienic surroundings, as pernicious diseases such as cholera, malaria , typhoid fever and asthma flourish under filthy conditions. Ultimately, every locality needs to take action to keep its environment clean, and people need to realize that garbage and filth in the neighborhood threatens them directly in their own homes, through a proliferation of files, cockroaches and mice. The need for preventive action outside the home (using garbage bins, keeping public toilets clean and keeping drains clear) is as important as preventive action inside the home (washing hands and feet thoroughly, washing vegetables properly, storing food safely, sweeping and swabbing the floor). It may be very difficult to organize the community, but if you do not, you may have to pay the price in the long run, by falling prey to a variety of diseases.
The connection between health and cleanliness had been recognized and respected even in ancient India. In order to remain healthy, a community must ensure the following:
- A regular supply of clean drinking water.
- Enough water for cleaning , bathing and washing clothes as well as for flushing toilets.
- Safe garbage disposal.
- Safe sanitation facilities.
- Clean pure air to breathe.
Unfortunately, virtually all over India, especially in the cities, the foregoing basic requirements are becoming the exception rather than the norm. While political action is needed to ensure that the government supply these basic amenities, there is little concerted action taken by most citizens, with the result that the situation is likely to deteriorate from bad to worse. Taking care of the environment is a key part of remaining healthy, and if the community is not healthy, it is difficult for an individual to remain healthy.
A promising recent development is the fact that builders are realizing the importance of providing a healthy environment and A lot of of them are now developing self-contained mini-townships, which provide all basic amenities within their four walls. These townships can be healthy places to live and bring up a family in, since they provide several essential features such as:
- lots of open space to play in;
- clubs and gymnasiums to remain fit and healthy;
- shopping arcades;
- food markets;
- chemists' shops; and
- clinics and hospitals.
However, while the quality of life is excellent for the residents of these townships, who form a privileged minority, what about the rest of the citizens? After all, if your domestic help and his/her family are going to live amidst filth, it is likely they will be afflicted by infectious diseases such as tuberculosis and typhoid, which they could then transmit to you and your family. In the final analysis, this is a problem which affects all of us and we simply can not afford to turn a blind eye to it! However, since it is a public health problem, we are usually content to let the government tackle it - which it fails to do in its usual characteristic fashion!
By contrast, citizens in developed countries of the world, have realized the menace of the problems created by unhygienic conditions and have collected together to lobby for change, in order to ensure healthy living conditions for themselves and their families. For example, environmental pollution affects the health of everyone, and you can not afford to neglect the fact that the air you breathe is going to contain more and more toxic matter as the days roll by. Similarly, while it is the municipal corporation's responsibility to provide us with clean drinking water and to dispose off garbage hygienically, we should also ensure that this job gets done!
The number of environmental health dangers is increasing daily. All of us are paying the price for industrial pollution. The 'litany of woes' is a long one! For instance: pesticides in our food; pollutants in the water; toxic fumes in the atmosphere; and harmful hormones in the milk we give our children to drink. We are bombarded by noise pollution daily which can cause numerous health dangers, including headaches, insomnia and hearing loss. People living in cities spend over 80 per cent of their time indoors, and indoor air pollutants can pose A lot of health risks, including an illness called the 'sick building syndrome'!
work-related exposure to toxic chemicals is also becoming increasingly common. However, the risk of exposure to these chemicals is no longer restricted to factory workers alone. The 1984 Bhopal gas tragedy is an outstanding example of how thousands were adversely affected because of the failure to implement simple precautions, even though the factory from which the deadly fumes emanated was dealing with toxic chemicals. The Bhopal tragedy is replayed almost daily on a much smaller scale in cities all over India; for instance, when a tanker carrying toxic chemicals overturns and releases its poisonous load into the environment, or when manufacturing units operating from residential areas spew out toxic waste products.
Effects of other toxins may be more subtle and hormone disrupters (such as industrial estrogenic chemicals) have been shown to decrease sperm counts in men all over the world ! Living safely in a polluted world is no easy task, and is likely to become increasingly difficult for our children, as these toxic accumulate agents can in the environment over decades.
The prevalence of illness is increasing rapidly in metropolises such as Mumbai and Delhi. This increase can be attributed primarily to overpopulation, poor sanitation and excessive pollution. Water- and food-borne diseases are endemic, and these diarrhoeal diseases have been the major killers, especially of children. Also, respiratory diseases (such as asthma and bronchitis) are beginning to pose an equally serious threat to life because of increasing levels of air pollution.
Keeping in mind all the foregoing factors, we simply can not afford to continue to live in our own shells! In the final analysis, health is a political matter, and the types of illnesses found in society are reflection of the nature of that society. Illnesses do not hit all groups in society randomly and equally, and just as wealth is unequally distributed in Indian society, so is ill health. One of the best predictors of a person's life expectancy is his annual income and extensive research has proven that A lot of illnesses have their origins in social conditions. The difference starts right from childhood, and poor nutrition means that the children of the poor are shorter, weaker, sicker and thinner than those of the rich --- even at birth.
Although an individual's life expectancy has increased, the gap in life expectancy between the poor and the rich has also continued to increase all over the world. According to a analysis of global health by the World Health Organization, poverty was the greatest underlying cause of disease, leaving A lot of with inadequate access to nutrition, drugs and basic health care. Those living in poverty must focus on survival priorities and often don't have the time or the energy to prevent or treat illnesses, until they are forced to . Leading a hand-to-mouth existence means falling ill is a luxury they really can not afford! Unfortunately, A lot of doctors and hospitals fail to treat the poor as well as they would treat the rich, so that A lot of simply avoid doctors and hospitals completely because of inferior care.
Political problems need political solutions, but governments in India have done precious little for providing health care for the common man. They make grandiose plans for a primary health centre in each village, but typically these PHCs have no medicines or supplies, because they have been siphoned off. They build expensive super speciality hospitals in cities, but most of these just end up as a palace of diseases, while the poor continue to die without food and shelter.
In fact, the entire health care system is ill! It concentrates on treating the sick, but does little to prevent them from becoming so. In fact, the term 'health care' system, which takes care only of the sick. It treats only individuals, but does not attack the basic causes of illnesses, such as poverty and illiteracy. Far from encouraging people to lead healthy lives, our society encourages them to harm themselves, and a prime example is cigarette smoking. Unfortunately, profits come before people --- and there are too A lot of people making too much money from tobacco, so that the tobacco industry continues to spend billions a year encouraging people to smoke, and the government allows them to do so. The question is: what sort of society lets a small group of people persuade the masses to engage in behavior which might kill them --- and then provides medical care to try to save them?
We still continue to take a piecemeal approach to treating disease on a case-by-case basis, but this approach is doomed to fail in the long run. Let's take the example of bronchitis. At present, we treat only those individuals who are suffering from the disease. However, a social approach to treating bronchitis would focus on removing those factors in the environment which are known to cause or aggravate bronchitis, such as air pollution, poor working conditions, industrial pollution and cigarette smoking. While the modern medical system is designed to look after ill patients, we can not improve the health of our community without taking concerted political action!
All political action, however, starts with an individual's initiative. Doctors in India constantly complain about the shortage of safe blood banks. Isn't this state of affairs tragic in an overpopulated country like India (where one would imagine that there would be no shortage of people willing to donate blood). When was the last time you donated blood? If we do not develop a social conscience, we will not be able to improve our community's health, and we will all pay the price sooner than later.
A healthy community looks after the health of all its members, including the underprivileged. It protects the rights of the disabled and treats them respectfully as individuals who are 'differently abled', and also develops active programs for preventing and treating drug abuse and alcohol abuse. Progressive community also provide hotlines for suicide prevention as well as counseling, so that people have someone to reach out to and talk to.
So much for a vision of what a healthy society should be. As an individual, what you can do to improve your community's health is to participate actively and to volunteer your services in various fields: for example, as a guide in hospitals; to lobby against polluting industries; or to care for older citizens. Improving a community's health can be the entry point for improving the quality of life for the entire community! Remember, that by helping to improve the health of the community, you are helping yourself and your children!
