India has always been a spiritual nation. For the last 5000 years, we have believed that the source of our mental happiness and wellness is based on our spiritual way of life.
But the modern mechanical world has in a way disrupted that pattern and in the last 50 years, we have seen an increase in cases requiring mental wellness intervention. We also see an increase in cases where patients need counseling and therapy. While this is still an emerging trend it is believed that this year 2020, more than 20% of our po[ulation needs mental wellness interventions.
Covid19 has exposed the need for the same. It is believed that the number of people requiring treatment is almost 25% more than previously anticipated. Also, the infrastructure in terms of doctors, psychiatrists, and counselors is just not there. To discuss this and more Dr Sumeet Kad and I took up this issue in our third episode of India Health Talk. The link is below.
On the positive side, there is an increased awareness of the situation, also due to the rise of telemedicine, we would see an increase in the number of teleconsultations. However, the key is to increase awareness and not take your mental wellness for granted.
Smoking is bad for health. Period. I think that debate has been over for a long time. The idea of having a smoke once in a while is not so bad as the addictive nature of cigarettes. The same I can say for all forms of Tobacco consumed in India.
Smoking is not a few phenomena in the country. There is evidence of Bhang and Cannabis consumption for almost 2000 years. It is even prescribed in ancient texts as a medicinal practice to manage pain and neurological disorders. Most recently Hookah has been used by both the royalty as well as the common people.
Now tobacco accounts for almost 10 million deaths in the country. Add to it the impact it has on the cardiovascular system and respiratory system would make it a very lethal habit to cultivate. Cigarettes for example contain more than 7000 chemicals out of which more than 250 are harmful and more than 60 are carcinogenic. This brings me to Cancer which continues unabated in the country. Non Communicable diseases also continue to be boosted by the habit of chewing and smoking tobacco.
While India has implemented many laws including Cigarettes and Other Tobacco Products Act (COTPA) with the creation of a National Tobacco Control Programme (NTCP) in 2007. But the real reason why Indian government can never control or remove tobacco is the economics of it.
Today the tobacco industry caters to almost 120 million customers in India. The vast majority of tobacco is grown in Karnataka, Andhra, and Gujrat. Almost 50% of the tobacco consumed in India is the chewable type used in Gutka, Khaini and Zarda. Almost 30 % as bidis and only about 20% as cigarettes.
The below graphs give us a sense of the revenues from tobacco. This graph is particular to the cigarettes and the tax collection from smokers in the last decade.
There are many measures for controlling the consumption of cigarettes, there are Laws like COPTA, the ban on advertising, and the increasing control of public smoking in the country. But then who would kill the golden goose that gives almost 30,000 crores of revenue to the government from sale of tobacco products.
So on this World No Tobacco Day, I started thinking about what can be done to control the habit and reduce the disease burden of cigarettes while balancing the loss of revenue to the government?
Here is what I think can be done
Treat smoking or chewing of tobacco as addiction. These individuals should enter therapy just like how we would expect people with drug addiction to undergo therapy.
Focus on nutrition and health for the rural areas. One of the reasons why tobacco consumption is very popular, is because many people do not receive adequate nutrition. Tobacco consumption quells hunger and thats the sole reason why it should be tackled.
Create smoking zones and tobacco consumption zones all over cities to ensure that the concentration of efforts to manage the communication and addiction can be well coordinated. Ban all consumption outside of these zone.
But the biggest challenge is how can the government substitute the 43,000 crores that it receives from tobacco sales. Now that is a question I leave open for economists. Do let me know how and I would be happy to make that discussion to the right authorities.
Just this week, we recorded the second episode for the India Health Talk, with Dr Sumeet Kad. During the recording we ended up discussing the privacy concerns around Aarogya Setu, the contact tracing application launched by the Government of India to track Covid19 cases in the country. Aarognya Setu today has more than 10 Crore downloads and is the largest contact tracing application in the world. How do we balance the privacy concerns with managing a pandemic like Covid19? Alo what can we learn about other applications across the world in this space?
While I understand the concerns, in my opinion, during a pandemic we may need to give up some control over our data and privacy for the greater good of society. Pandemic is a national emergency and Covid19 is probably the worst example of it. But using privacy to derail the efforts to combat Covid19 is not a good idea. In the long run this may be our downfall.
Below is the full recording of the episode. Do let me know your thoughts as well.
Just a few days ago I was on a webinar on Healthcare. The topic was the use of AI in Healthcare and the implications of Ethics in the same.
While all panelists spoke eloquently about the topic, I was trying to recall where have I seen AI in action in India. Unable to find too many instances, I spoke to my good friend and the editor of the New Age Healthcare Website Dr Sumeet Kad. Below is a recording of our interesting conversation.
It was ironic as MCI and other state associations have been fighting a battle to stop teleconsultations and putting regulations around it. But the coming of Covid19 has changed all that.
Today after a long time we have a spurt in telemedicine providers in India. Industry experts like Bharat Gera former CIO of St Johns Hospital, are working with bodies like Telemedicine Society of India to put in a process to benchmark the functionality of these providers.
In the long run, I see this as a very positive move for senior citizens. These individuals fight it difficult to access healthcare. Especially as they have chronic conditions that need management, right from transportation, to long hours in the waiting room.
To discuss this and other associated topics, I got together with industry experts like Ravi Ramaswamy from Philips to discuss the impact telemedicine would have on seniors. We were joined by Dr Neeraj Bhalla and Dr Vallikiran to discuss the impact on areas like Cardiology and Psychiatry respectively.
The recording of the session is below.
I believe that Telemedicine is a boon to seniors. There would be a learning curve with respect to getting used to the platform, training to caregivers, and then managing concerns like security. But I think Telemedicine is here to stay.